Online Distributor/Importer Application (or PDF format)

 

Thank you for taking the time to fill out the Chanson Water Distributor/ Importer Application form. We will contact you once we have reviewed all of your company information, and let you know the appropriate next steps.

Please review the application in its entirety, any missing information could result in a delay in processing.

Contact Information

Business Name

Business Address

City:

State Province:

Zip Postal Code:

Country:

Contact Person

Title

Phone Number

Fax Number

Email:

Territory you are requesting:


Business Information

How long has the business been operating?

Brief description of your business

How do you plan to sell Chanson products (example: internet sales, trade shows, e.t.c ):

How many employees/persons will work full time to sell Chanson products:

How many employees/ persons will work part time to sell Chanson products:

List the dollar ($) amount you have budgeted to start your Chanson business (you can list a range for example: $5000.00 - $100,000.00):

Give a brief description of your business plan:

Developing a successful Chanson business does not happen overnight, it takes time and commitment, what is your time commitment for this business?

What is your desired outcome for this business? (what is your goal):

Chanson Product Info:

Will you require private labeled products or Chanson branded products:

captcha

Please verify your humanity: (To help us prevent spam)