Become a Distributer

APPLICATION FOR BUSINESS ACCOUNT

BUSINESS CONTACT INFORMATION

Name *

Date business Commenced *

Company Name *

Type of Firm *

Phone *

Email *

Country *

State *

City *

Street Number *

Street Name *

State Zip Code *

BUSINESS INFORMATION

Current Turnover *

Number of Employees *

Current Stock Supplier

Years Trading *

Main Focus(events, retail etc)

Do you require in House service

BUSINESS/TRADE REFERENCES

Company Name *

Phone

Country *

State *

City *

Street Number *

Street Name *

ZIP code *

Email *

Type of Account *

Fax *

Other *

Company Name *

Phone

Country *

State *

City *

Street Number *

Street Name *

ZIP code *

Email *

Type of Account *

Fax *

Other *

Company Name *

Phone

Country *

State *

City *

Street Number *

Street Name *

ZIP code *

Email *

Type of Account *

Fax *

Other *

AGREEMENT

1. Terms 50% Deposit to commence production with balance prior to release of goods.

2. Claims arising from invoices must be made within seven working days.

3. By submitting this application, you authorize DIOZ GROUP to make inquiries into the banking and business/trade references that you have supplied.

SIGNATURES

Signature *

Signature

Title *

Title

Name *

Name

Date *

Date