DISTRIBUTOR
DAP APPLICATION PROCESS

You can apply online with us. We are happy to take you as a prospect dealer or service partner.
Please complete the form below with your details. Mandatory fields, which must be filled out are marked with a *.
In accordance with our Privacy Policy your data will be stored only on of your personal request and will be not passed on to third parties.

YOUR PERSONAL DATA
Name, Firstname:*
Company:
Company form:
Street, Address:
ZIP, Town
Phone company:
Phone or Mobile (private):
Preferred contact by: Email Phonecall Visit
Your Email:

MORE ABOUT YOUR COMPANY
Branches: Yes No
Employed staff:
Turnover in 2012:
Existing other dealer contract: Yes No
Financial partner/bank:
Certification (ISO etc.):

MARKET POTENTIAL
 
How many MIKENO MPV you think you are able to sell within one year:
Remarks:
Everything o.k.?