Form

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Please fill in this form. Company Name………………………………………………………………………………………………………. Address/City/State….………………………………………………………………………………………………… Tel./Fax No……………………………………………………………………………………………………………. E-mail…………………………………………………………web site……………………………………………… Contact Person….......................…………………………………………………………………………………… Position…………………………………………………………………………………………………………………

1) Have you already purchased branded items? 2) Where ? (Country/City)

3) What is your minimum purchase for each time ? (EUR)

o

5.000,00-10.000,00

o

10.000,00-30.000,00

o

o

300.000,00 1.000.000,00

o

1.000.000,00 10.000.000,00

o

30.000,0050.000,00 Above 10.000.000,00

o

50.000,00 100.000,00

o

o

o

o o

o o

4) What is your minimum purchase yearly ? (EUR)

o o

o o

o o

5) Which Brands would you like to buy ?

6) What are the product you are interested in ?

o o

Man Clothing Woman Clothing

o o

Accessories Underwear

o o

Sportware Classic

7) When do you plan on placing your next order ?

o o

Sunglasses

o o

100.000,00 300.000,00


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