Distributor Application

Thank you for your interest in distributing Advanced Biotechnologies Inc Products.
We are happy to announce that we are accepting your distributor application at this time.

The distributor application will be available until Monday, December 1, 2008. It should only take a few minutes to fill out. The information on the form is important for us to evaluate the market you will be distributing in, and your capabilities as a distributor. We will review your application immediately, and you will be notified via email if you have been selected to become a distributor.

Upon being chosen as a distributor, you will receive a distributor agreement to sign. Disclosed in this agreement will be the term of your distribution, discount and payment information, and additional policies. This Distributor Agreement Form must be returned no later than Monday, December 15th. Your discount will begin upon receiving this signed document.

Important Dates:
Dec 1: Last day to complete the online Distributor Application
Dec 15: Distributor Application must be signed and returned to ABI

Company Data

Please enter the name of your organization

Please provide the address (including country) of the office we will be conducting business with.

Please list the countries you are able to distribute our products in.

In what year was your organization founded?

Please provide your VAT or government tax ID number. This will aid in delivering shipments to you efficiently.

Please enter your Dunn & Bradstreet number, if available

Please estimate the estimated purchases of ABI products over the first six months

e.g., cold calls, etc.

Primary Contact