Personal Information

Contact Name: (required) *

Title: (required) *

Your Email: (required) *

Telephone: (required) *

REGISTRATION AND LICENSING

Provide information relevant to the registration process, associated cost and timeframe for the registration and legalization for each product and/or the brand.:

SAN expects to retain ownership / title to registration number / ID / protocol issued for the legal importation of said products. Explain how this would work.:

Please calculate 1st year sales (use an excel spreadsheet) and supply supportive rationale as an attachment to this form:

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ORDERING LOGISTICS

Ports to be used - Pick Up:

Ports to be used - Delivery:

PAYMENT INFORMATION

Name:

Title:

Email:

Phone:

SHIP TO INFORMATION

Name:

Address:

City / State / Province:

Country:

Phone:

Is a Certificate of Insurance required with each shipment?:

FREIGHT FORWARDER INFORMATION

Name of Contact:

Address:

Email:

Website:

DOCUMENTS

Please indicate which documents are required with each shipment:

Please list all countries where you are requesting distribution rights:

ADDITOINAL INFORMATION

Document Upload:

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Document Upload #2:

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Other Comments or Questions?: Dear Sir/Madam

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Thank you for getting in touch!

We appreciate you contacting us. One of our colleagues will get back in touch with you soon!

Have a great day!

Personal Information

COMPANY INFORMATION

REGISTRATION AND LICENSING

ORDERING LOGISTICS

PAYMENT INFORMATION

SHIP TO INFORMATION

FREIGHT FORWARDER INFORMATION

DOCUMENTS

ADDITOINAL INFORMATION

Thank you for getting in touch!

Thank you for getting in touch!

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