1) General Information

i. Company/Individual Name:

ii. Address:

iii. Country:

iv. Tel: v.  Fax:

vi. Website:

vii. Email:

2) Company History and Structure

i. Year in which company was established:

ii. Is your company incorporated? Year:

iii. Number of current employees:

iv. Is the company privately owned/publicly traded corporation:

v.Names and Titles of senior executives or officers of the company:


vi. Professional background. Please provide details.

3) Products and Services

i. Product/Service Description

4) Sales Channel

i. Which is your current territory of coverage? Please describe:

ii. Which are your major customer groups?

iii. What methods do you use to promote products & services to your major customers? Please describe:

iv. Do you sell regionally, or nationally, or internationally? A few details please:

v. Do you provide customer service (after-sales service) for your products or services? Please provide a brief description:

vi. Do you have a warehouse to store inventory?

vii. Do you have to provide technical support for any of your products or services? Please provide a brief description.

viii. Do you presently represent/promote any other similar products? Please provide some details:

5) Company Goals and Strategies

i. What opportunities do you see for distributing our products/services in your territory?

ii. What would be your estimate on the volume of business you could do in your territory in the first 12 months?

iii. What sales & marketing strategies would you use in your territory?



iv. When do you plan to start this business or incorporate this product into your current business set-up?


List of Attachments to be submitted with this Questionaire

It would be very helpful to us if you could submit as many of the requested items as possible. All items submitted will be treated confidentially.

1. Product brochures and all other marketing collateral material (if available)
2. Supporting documents eg. ROC (Form 9 or 13), ROB (Form D), ROS etc.
3. Business references from banks and suppliers.
4. Testimonials from customers (if available).
5. List of contacts at company with whom we would be dealing.

Name of Person submitting this form: