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Home / Contact Us / Form for Dealer
Form for Dealer
Note: All fields are mandatory

Name and Address of Organisation
Phone no.
Fax no.
Mobile no.
Contact Person
Designation
Name and Address of the Banker
Type of Business.
Proprietary
Partnership
Pvt. Ltd.
Public Ltd.
Year of starting business
Turnover in past 3 years
(in Rs. Lacs)
     
Promoters
Name
Designation
Brief
Background
Is the promoter related to any of Kisan Employees?
Yes
No
Professional Strength
Marketing Executive
Customer Support Officers
Skilled Laborer's
Plumbers
Others
Facilities available (kindly mention the addresses)
Office
Showroom
Godown
What do you perceive as your strengths?(Please tick and give comments if necessary)
Ability to market
Understanding of market segments
Financial strength
Establishment reputation
Which markets do you feel confident in selling?
Corporate
Industry
Retail
Education
Govt. & Govt. undertakings
Others
Which geographical areas would you like to cover?
Please give us your estimate of the total potential for our products in your area, in terms of Net Sales Value for the next 3 years
Do you undertake any local advertising for various products that you are already handling at present? If yes, what is the approximate annual outlay?
Yes
No
Any additional information which may be of relevance?