DISTRIBUTOR APPLICATION FORM - OPHTHALMIC

Kindly complete this application for Rumex to consider your company as a distributor. Please, try to answer all questions, it will not take much time.

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* 1. Company name

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* 2. Company contact details (address, city, state, country, telephone, e-mail, website)

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* 3. Country profile

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* 4. Company sales per year

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* 5. Quantity of personnel in your company

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* 6. How many years is your company in business?

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* 7. Contacts of key personnel (name, job position, experience is sales of ophthalmic products)

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* 8. Territory/regions covered by your company

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* 9. Other producers/distributors represented in your region/territory os sales (company name(s)

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* 10. What is your primary method of customer contact?

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* 11. Do you visit manufacturers production sites?

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* 12. Do you exhibit at medical meetings/congresses?

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* 13. Does your company organize surgeon workshops?

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* 14. Do you make direct mailings to customers?

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* 15. Do you submit regular sales reports and forecasts to manufacturers you represent?

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* 16. How do you advertise?

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* 17. What is your normal inventory stocking policy?

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* 18. Bank references (bank name, address, account information)

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* 19. What are the specific characteristics of the ophthalmic market in your country?

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* 20. What are the major meetings/congresses you would attend and exhibit in your territory?

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* 21. Do you participate in tenders? What are the approximate delivery terms?

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* 22. What are the most popular brands in your country?

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* 23. Are any ophthalmic instruments produced in your county?

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* 24. What types of surgeries are popular (and/or becoming popular) in your country?

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* 25. What are the main reasons and purpose for your company to become a distributor of Rumex products?

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* 26. Would you consider opening a special division for the Rumex products and hire a dedicated clinical specialist for Rumex products?

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* 27. How many customers that use surgical instruments do you have?

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* 28. How many of your customers use Rumex products?

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* 29. Which is your estimate of annual sales in your territoty (all brands)?

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* 30. How many doctors are in your territory? (Indicate quantity of specialists if you know that. Total quantity is not expected to be a sum of specialists, as many doctors are involved in different specialties at the same time)

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* 31. What customs duty rates must you pay to import items from Rumex?

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* 32. What is your yearly sales expectation for Rumex products?

Thank you for your time! In hope for future partnership, your Rumex team!

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