Today's Date *

Date

Vendor Details

Company Name *

Contact Number *

Company Email *

example@example.com

Website URL

Office Address *

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Business Organization Type *

Corporation
Partnership
Sole Proprietorship

Year the Company was founded (since) *

e.g since 2003

Vendor Type *

International
Local

Nature of Business/Trade *

Manufacturer
Authorized Dealer
Wholesaler
Retailer
Importer
Other

Please specify: *

Types of Products and Services Provided *

Convenience Products
Shopping Products
Specialty Products
Other

Please specify: *

Company Description

Shipping Method

Lead Time

Product(s) List/Description

Upload Product Images

Accepted Payment Method

Check, bank transfer, purchase order, credit card

Contact Person Details

Contact Person #1

Name

Phone Number

Email Address

Position

Contact Person #2

Name

Phone Number

Email Address

Position

Contact Person #3

Name

Phone Number

Email Address

Position

I confirm that all information in this document is true to the best of my knowledge. *

Vendor's Representative Name

First Name

Last Name

Vendor's Representative Email

example@example.com

Vendor's Representative Signature

Please type in your name *

Date Signed

Date

Vendor Information Form

Vendor Details

Thanks for getting in touch!

Thanks for getting in touch!

Les Vagabondes - Montaclier

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