Channel Partner Application Form

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Company Name *

Organization Type *

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Established *

State *

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City *

Contact person name *

Authorised Signatory *

Phone Number *

Email Address *

GST NO *

GST Copy *

📎 Choose file

PAN Copy *

📎 Choose file

CIN copy *

📎 Choose file

Have Udyam Registered? *

Yes No

Cancelled Cheque *

📎 Choose file

Last years turnover *

₹

No. of employees *

Five largest customer names *

Major revenue generating product line *

Promoters professional experience *

Do you distribute any competitive product similar to Aquasense *

YES NO

Estimated business plan/volume for current financial year in INR with Aquasense *

₹

Geographical presence/service area *

Do you deal with government tenders *

YES NO

Your strong market area *

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