EIL TELECOM LIMITED
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EIL Distributor Application
(EIL TELECOM PRODUCTS)
1. Company Information:
Company Name:
Corportation
Partnership
Subsidiary or Branch-Office
Sole Proprietorship
Year Established:
1a. Mailing and Billing Address:
Address 1:
Address 2:
City
State/Province
Postal Code
Country
1a. Shipping Address (No P.O. Boxes):
Address 1:
Address 2:
City
State/Province
Postal Code
Country
Is this the primary location?
Yes
No If there are other direct company locations, how many?
(Please provide list of locations with contact info on an attached document.)
2. Contact Information:
Primary Telephone #:
Fax #:
Principal Contact #:
Title:
Phone #:
E-mail Address:
Technical Contact:
Title:
Phone #:
E-mail Address
Sales Contact:
Title:
Phone #:
E-mail Address
3. Business Profile
3a. How long has your company been in business?
3b. What is your approximate annual sales revenue?
N500K
N500K - N1M
N1M - N5M
N5M - N10M
N10M - N50M
N50M
3c. What is your primary geographical coverage?
Local
Regional
National
International (List countries):
3d. How many sales representatives does your company have?
1 - 3
4 - 8
9 - 15
>15
4. Business Goals
Decribe your business goals for the EIL product line e.g. Estimated Quarterly and annual turnover
5. Communications
5a. What distributors do you purchase products from? List:
6. Application Review
This application is being submitted for the sole purpose of becoming an EIL Authorized Reseller. The Applicant understands and agrees that this application does not ensure that the Applicant will be chosen as an Authorized reseller.
If you have questions, contact EIL Sales at:
EIL Telecom Limited
7c Oduduwa Way
Ikeja G.R.A
Lagos, Nigeria
Tel: 234-1-4979321-2
Fax: 234-1-4968486
Completing all sections of this application helps us determine your eligibility and develop our relationship with you. Please fill out in as much detail as possible.
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2006 EIL Telecom Limited.
All Rights Reserved.