Apply for Dealership

 

Fields marked with * are required.

Name of the Firm *:
Address (Please mention land mark, if any).
Name of the Proprietor *:
Res. Phone No.:
Mobile No.:
Name of the Partner :
Res. Phone No.:
Mobile No.:
Office Phone Nos. * :
Fax No.:
Email * :
Name & Res. Phone No. of contact person/s *
Nature of business
Annual turnover for 2014-15 :
Annual turnover for 2013-14 :
Annual turnover for 2012-13 :
Name of the Products marketed *
(C.S.T)TIN Number:
Permanent A\c no.[PAN] :
Name & Address of your Banker:
Manpower employed (Pl. furnish details):
Facilities available for effective after-sales-service:
Geographical area in which you are actively marketing other products.:
Are you already registered with Ajmer Thermotech as a Dealer? If yes, please specify products.:
Please name some of your important customers: