DISTRIBUTOR APPLICATION FORM

The following information must be provided in order to be apply for distributorship of Infinity SAV’ products.
Please provide as much information as possible.

DISCLAIMER: THIS APPLICATION FORM DOES NOT CONSTITUTE A CONTRACT. INFINITY SAV
RESERVES THE RIGHT TO ACCEPT OR REJECT THIS APPLICATION AT OUR DISCRETION.

I. COMPANY INFORMATION

Company Name:
Street Address:
City/State/Province:
Country:
Telephone Number: -
Country Code Main Number Extension, if any

Person to Contact:
Title:
E-mail Address:
Mobile Number:
Company Website:
Please indicate below, your type of business:

□ Manufacturer □Distributor
□Broker/Trading Company □Marketing Company □Other describe below
II. ORGANIZATION

1) What year was your business established?

2) How many people does your company employ?

3) How many sales representatives are in your company?

4) Does your company sell through independent sales representatives, agents or

distributors? □YES □NO

If “yes”, please provide a brief explanation of the number and type of other sales:

____

III. TERRITORY

1. The territory / country you would like to represent

Do you have sufficient financial capabilities to acquire a Distributorship License?

□YES □NO
2. Do you believe your company can fulfil all distributorship obligations outlined in the
Business Proposal and Exclusive Distributorship Agreement?

□YES □NO
3. What networking capabilities do you have to cover the above territory / country?
____
 ____

Please fill out the Distributor's Questionnaire and send it to us by e-mail

distributor@infinitysav.com

Thank you for taking the time to complete this Application Form. It is
important to us to insure that our distributors are knowledgeable of the
market, experienced in sales and marketing, and financially secure to
properly support the process.

Please outline your questions and/or comments along with submitting your
application via email.

Upon reviewing your information, we will contact you as soon as possible.

Thank you very much for your interested in our company.

The Infinity SAV Team