DEALERíS REQUEST FORM

We would like to appoint dealers in un-represented areas in Raigad District. If anyone wishes to apply for the dealership kindly submit the Dealer Request Form. On receipt of the same, we will call upon you to decide regarding the dealership.

 

* denotes required fields

*AREA FOR DEALERSHIP:

*NAME OF THE COMPANY:

*YEAR OF ESTABLISHMENT:

*CONTACT PERSON:

*STATUS:

*POSTAL ADDRESS: 

*CITY:

*PIN:
*PHONE OFFICE:
FAX:
MOBILE:
E-MAIL:

*BRIEF DESCRIPTION  

OF ITEMS YOU DEAL IN: 

Please press the Submit Form button once to send or press Clear All to clear this form