Hazcheck Systems Overview           Navigate           Key Services           Home           Contact Exis        

mail@existec.com
 
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): 
First Name: 
Last Name: 
Job Title: 
Company: 

Address: 
City/Town: 
Country: 
Post/Zip Code (if applicable): 
Tel: 
Fax: 
Email: 
Website URL: 
 
Business Category: 




  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

     Home      Email      Terms & Conditions      Copyright 2010      Updated 1st September 2010