Distributor appointment application

If you are an established retailer or distributor of publications and software or are a training operation for the freight transport industry, you are invited to apply to be a distributor of Exis Technologies software products for dangerous goods management. Please complete and submit this form. We look forward to talking to you!  YOUR DETAILS  Please note: All fields must be completed.   Title (e.g. Mr, Mrs):  > Select ...Mr.Mrs.Dr.Captain.Other First Name:  Last Name:  Job Title:  Company:  Address:  City/Town:  Country:  Post/Zip Code (if applicable):  Tel:  Fax:  Email:  Website URL:    Business Category:  > Select ... Agent Classification society Consultant Education & Training Forwarder/ consolidator Gov & Regulatory Auth Logistics Port & Terminal Operator Port Authority Ship Operator - Deepsea Ship Operator - Feeder Ship Operator - Ferry Shipper/ manufacturer Software and systems Surveyors Other (please state)   Please provide a brief description of your current sales/distribution business, in particular listing key clients and products and geographic areas. Please refer to relevant pages on your website. If you have any relevant brochures or promotional material, please mail them to me and check the box. If you have this in digital form, please e-mail to mail@existec.com. Promotional material will be mailed.    Thank you for your application. Ken Burgess, Director Exis Technologies 3 Trinity Court Faverdale North Darlington DL3 0PH UK