Medicine Mama's International Distributor Application

Please fill out the questions below

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* 1. Please provide us with some basic information about your company

Distributor name:

Distributor address:

Distributor website:

Point of contact name:

Contact information:

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* 2. What country or region do you represent?

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* 3. What are some other product lines that you currently represent?

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* 4. How many stores do you distribute or represent products to?

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* 5. What verticals do you sell into?

Organic / natural foods and supplement stores

Natural remedy or pharmacy stores

Beauty supply, skincare, or cosmetic stores

Other (please specify)

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* 6. Why are you interested in carrying our line of organic healing skin creams?

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* 7. What products are you most interested in distributing?

Sweet Bee Magic

Sweet Bee Magic Wand

Vmagic

Baby & Mama

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* 8. How did you hear about us?

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* 9. Please provide us with contact information for another company you currently represent as a reference.