DISTRIBUTOR APPLICATION FORM PRINT PAGE

 

Company Name:
Physical Address:
Country:
Postal Address:
Telephone: (International code)(area code)(number)
Fax: (International code)(area code)(number)
Website address:
Email address:
Contact Person:
Position:
Current Distribution Network (Countries / Areas):
Possible / Proposed distribution network (Countries / Areas):

Please supply us with a brief history of your company

When and how did your company start? What is your staff complement and what are your core competencies? Where are your offices located? How and when did you enter the infusion market? What is your annual turnover? Can you provide us with references?

Which products do you currently sell?

Is your focus on the infusion market? What specific products do you sell? Can you indicate what percentage of your turnover results from specific products?

Who are your current clients?
What percentage of your business results from relationships with either government or private hospitals or clinics? What legislation is required for distribution of products in government clinics?
Government Clinics
Private Hospitals/Clinics
Within these organisations, whom do you deal with?
Procurement
Management
Tenders
Ongoing sales
Which competitor products are distributed in your region?
Who are the biggest players in the market in your region? What market share do they hold?
It is the intention of varori international to offer high quality products at a competitive price. Are you familiar with the pricing structure of the competitors?
Please provide us with the range of prices for the products you distribute.
How would you propose introducing varori international products into the market?
What differentiates your company from competitors? Would you sell our products regionally or nationally?
What accreditation is required for the import of medical devices systems in your country?
Can you provide us with full details?
What other regulation governs import of medical devices in your country?
What is the taxation rate on medical devices? Does the government regulate mark-ups?