Sales Agency Grant Registration

Father:

Name & Family :

Phone:

Mobile:

Date of birth:

Gender: MaleFemale

Education: UndergraduateDiplomaPostgraduateBachelor'sMaster'sDoctorate

E-mail:

Marital status: MarriedSingle

Marital Date:

Store Name:

Postal Code:

Country:

City:

Store Address:

Store Area (Square Meters):

Ownership Type: Dedicated PropertyGoodwillRented Property

Activity History (Years):

Warehouse Address

Warehouse Area (Square Meters):

Order Procedure:Cash PurchaseCredit PurchaseCredit/Cash Purchase