WWW.CROMPTONPARTNER.CO.
IN
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Dealer Application Form
Please complete this form and Send it
To , Info@dealershipcrompton.in
Your Company Name:
Applicant Name:
Title:
Address:
City:
State:                       Zip                  Country
Years Established:
Email:
Fax Number:
Phone Number:
You’re Business Website Address:
Estimate the Number of customer who visits your shop each week:
How many Electronics International
Instruments do you hope to sell each month:
                                                                  Applicant Signature
                                                                WWW.CROMPTONPARTNER.CO.IN
Dealer Application Form
Are you (check appropriate box?
        Electricals Business                Hardware                Instrument Shop                 Other
What are your favorite features of our instrument?
Please explain how you intend to promote our products:
In order for us to authorize you as a new dealer, we must obtain information from other manufacturers who have previously
granted you dealership status. Please provide us with the following information on those manufacturers and the products you
distribute for them:
Manufacturer’s Name:
Products You Sell:
Alternate Phone Number:
Contact Name:                                         Printed Name:
Investment Capacity:                                      You’re Title:
Help Us
To authorize your company as a Crompton Greaves Dealer, be certain to include a copy of your business license, A&P or IA
Certificate and any other pertinent licenses and certificate with your completed Application Form.
                                                                                   Applicant Signature