Company logo

New Partner Application Form

Date  :

Please fill out the questions below, as accurately as possible. For all questions not applicable to your company, please indicate N/A.
FMS Tech. acknowledges the confidentiality of all information that will be taken from your answers in this questionnaire and that the information contained
in this document is true and accurate to the best of your knowledge.

GENERAL INFORMATION :
Company Name  :
Name of Representative  :
Designation  :
Address  :
Company E-mail Address  :
Company Telephone No.  :
Fax No.  :
Skype Name  :
Twitter Name  :
Company Organization  :
Country Organized  :
Date Organized  :
Principal Officers and Owners :
1 - Name :
Title  :
Email  :

More Add Click. .

2 - Name :
Title  :
Email  :

More Add Click. .

3 - Name :
Title  :
Email  :
If you are a subsidiary, please provide the information of your parent company below  :
Company Name  :
Street Address  :
City  :
State / Province  :
Postal Code  :
Country  :
Telephone No.  :
Fax No.  :
Describe your company’s major business activity .
1 - Name of Branch :
Name of Representative :
Telephone No.  :
E-mail  :

More Add Click..

2 - Name of Branch :
Name of Representative  :
Telephone No.  :
E-mail  :

More Add Click..

3 - Name of Branch  :
Name of Representative  :
Telephone No.  :
E-mail  :

Sales (U.S. Dollars) for the last year  :
Sales (U.S. Dollars) for the current year  :
Sales Forecast  :
Your company’s paid-in capital  :
Bank Name and Address  :
Name  :
Street Address  :
City  :
State / Province  :
Postal Code  :
Country  :
Telephone No.  :
Fax No.  :
Business References  :
1 - Name of Business  :
Street Address  :
City  :
State / Province  :
Postal Code  :
Country  :
Name of Contact  :
Email  :
Phone No.  :
Fax No.  :

More Add Click..

2 - Name of Business  :
Street Address  :
City  :
State / Province  :
Postal Code  :
Country  :
Name of Contact  :
Email  :
Phone No.  :
Fax No.  :

More Add Click..

3 - Name of Business  :
Street Address  :
City  :
State / Province  :
Postal Code  :
Country  :
Name of Contact  :
Email  :
Phone No.  :
Fax No.  :

More Add Click..

4 - Name of Business  :
Street Address  :
City  :
State / Province  :
Postal Code  :
Country  :
Name of Contact  :
Email  :
Phone No.  :
Fax No.  :
COMMERCIAL INFORMATION :
  • Are you currently a representative, dealer, or distributor of any Information Technology products ?
  • Are you currently a dealer or distributor ?
  • Are you currently a representative, dealer, or distributor of any other products or industries ? If yes, please list below :
1.
2.
3.
  • Is this representation/distribution your only business activity ? If no, please list your other businesses below :
1.
2.
3.
  • Are you currently a dealer or distributor of Information Technology or any other products and services in the
    Oil and Gas industry in your country or other country ? If yes, please list the products and services you provide :
1.
2.
3.
If you have a brochure or line card with all of the companies you represent, please attach it to this document .
  • What Market Verticals do you work with ?
  • What is your approach to selling in your market ?
  • What is the approximate volume of Business ?
  • How is the volume allocated over the companies you represent ?
  • How many employees do you have in total and how many are devoted to this part of your business ?
  • How long have you been in the business ?
  • What was your turnover for the last 3 years?
Please list the FMS Tech. products you are interested in selling :
  • Are you currently a representative or agent for any other company that manufactures products that are similar to our products ?
    If yes, please list the company name(s) below :
1.
2.
3.
  • Can you help us understand the size of the market for our products ?
    Please provide examples of other products and compare your country to another country, it would be helpful :
  • What can you advise about the demand of our product(s) in your country ?
  • What are the projected sales of all your products for the next fiscal year (U.S. Dollars) ?
  • What are the projected sales of our products for the next fiscal year (U.S. Dollars) ?
  • Will you maintain equipment/product for demonstration in your country ?
REGULATORY INFORMATION  :
  • What is the regulatory process for importing telecommunication / GPS products into your country?
  • Do you have approved licenses issued by the government to import GPS, satellite, MDVR, etc. ?
    If yes, please list down the licenses and their description/ products approved .
TECHNICAL SUPPORT  :
FMS Tech. believes that it is very important that we can provide our customers technical support (e.g. provide recommended specimen preparation
procedures, set-up and demo the equipment, etc.)
  • Do you have any persons within your organization that have experience in Fleet Management device preparation ?
  • Would you be willing to send someone from your organization to attend one of our partner preparation training courses in Abu Dhabi, UAE ?
SERVICE INFORMATION  :
  • Although we design the equipment to be easy to service, we still highly recommend that you attend one of our service training seminars. Would you be interested in attending one of our service training seminars ?
FINANCIAL INFORMATION  :
1 - Bank Name  :
Address  :
Bank Representative for Reference  :
Contact No  :
Email  :

More Add Click..

2 - Bank Name  :
Address  :
Bank Representative for Reference  :
Contact No  :
Email  :
  • Do you have any credit facilities with any of your banks?
Please include a financial statement for the last 3 years and/or marketing report with this document.
Also, attach any additional relevant documents, or comments that may be helpful to our evaluation. Thank you.
SIGNATURE  :
Questionnaire completed by  :
Name
Title
Signature
Date