Wholesale/Distributor Application

Distributor name *

Company legal name *

Address Line 1 *

Address Line 2

City *

Province/State/Region *

Country *

Company Owner Full Name *

Email *

Website

Phone Number *

What year was your company established *

What market segment do you represent * Baby Gift shop Department store Supermarket Pharmacy Other

What type of entity * Agent Distributor

Countries of distribution *

How many sales representatives/agents work for the company *

How many retailers do you have active relationships with (i.e. sales in the past 12 months) *

How many brands do you currently sell *

What language(s) is required for the packaging in your country *

Brief description of your company and why its a good match for Melii *

How do you plan to market Melii products *