:: VANI PRIVATE LIMITED ::

	Become a Retailer form

	Want us be your Dealer

	Contact Us

Thank you for your keen interest in appointing us as one of your distributors. We would really appreciate it if you could spend a couple of minutes filling out the form below. Once this form reaches us a manager will get back to you at the earliest with the information you requested for.

Company Name *

Brand Name

Manager’s Name*

Address*

Telephone Number*

Telephone Number 2

Fax Number

Mobile Number

E-mail Address

Website

Do you presently have a relationship with Vani?

Yes

What kind of products do you want us to be a distributor for? *

How long have the above mentioned products been in the market?

Do you have any other distributors for the above mentioned products in the South / Karnataka region?

Yes

If yes… who?

Why do you want Vani to be your distributor?

How did you hear about us?

Items marked with * are compulsory

Thank you for your time and interest once again. We look forward to doing business with you in the future!

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