Distributor Pre-qualification Application Form

Biomassters, Inc. respects the privacy of all distributors & customers, and as such, any/all information herein will be held in strict confidence and not shared with anyone.

Contact Info

Contact's Name * Contact's Position * Contact's Email *

Cell Phone # Work Phone # Fax #

Company Info

Company Name * Street Address * City *

State/Town * Postal Code * Country * Web Site *

In Business Since * # of Employees * # of Customers/Accounts * Annual Volume *

Other Information About Your Business/Company

Explain your ag. business (1500 chars left) * Where do you do business? (1500 chars left) * Additional information (1500 chars left)

Misc

How did you hear about us? (500 chars left) * References (1500 chars left)

File Upload

MOST IMPORTANT:

Please include a company profile or executive summary, literature, brochures, LOI, or any other company materials you feel are pertinent for us to acquaint outselves with your interest and capabilities.

Co. Profile or Exec. Summary Brochures/Literature LOI Misc Other

Signature

By entering your name, position, and email address below, you are certifying that all of the information entered, uploaded, and/or otherwise provided in this form is accurate and that you are authorized to provide/disclose it.