Distributor enquiry form

Are you interested in being a distributor? We would love to hear from you.
Just complete the form below.
Please fill in as much information as possible and submit it to us.
Fields marked * are required

* Name:		* Position:
* Company Name:		* Street:
* Post Code:		* City:
* Suburb:		* Country:
Telephone:		Fax:
* E-mail address:		Web site:
Year of establishment:
Total employees:
Technical/service employees:
Sales employees:
Employees dedicated to sales of Oxymat products:
ISO certification or quality management:
Desired geografical area (country/region):
Main business area / important applications:
Other business areas:
Do you have your own sales materials/brochure:
Ownership/structure of the company:
Company turnover in 2005 [€]:
Company turnover in 2006 [€]:
The net profit in 2005 [€]:
The net profit in 2006 [€]:
Own capital [€]:
Experience with oxygen- and nitrogen generators [years]:
Experience with industrial gasses [years]:
Business language:
Are your staff able to follow English instructions:
Local competitors or substitute suppliers:
Expected sales volume and capacities within std.range:
How often do you update your website:
Present arrangements with other suppliers:
Previous arrangements with other suppliers:
Planned marketing:
Costs of marketing last year:
Costs of marketing the present year:
Planned exhibitions:
Previous exhibitions:

Any other comments, descriptions or details that would help us to get to know you: