MJDECOR INC

No. 101 19th Ave. Dist. III, Brgy. San Roque, Cubao Quezon City
Contact Nos. 02-932-8888 | 0947-947-8888 | 0917-694-8888
E-mail Address: mjdecor888@gmail.com
websites: www.mjdecor888blinds.com

DEALER APPLICATION FORM

Please attach the following with the application:

( ) Company Profile
( ) Location Map
( ) List of Company Officers and Staff
( ) Photograph of Store of Office Frontage and Display area

COMPANY BACKGROUND

DATE:
Company Name__________________________________________________________
Contact Person ___________________________________Title ____________________
Address________________________________________________________________
_______________________________________________________________________
Phone ____________________________ Mobile _____________________________
Website ______________________________ Email ____________________________
Type of Organization: ( ) Proprietorship ( ) Partnership ( ) Corporation
Nature of Business ____________________________________Years in Business ____

______________________________________________
Signature Over Printed Name/Authorized Representative

Note: Please attached Photocopy of the following:

1) Representative 2 Valid Gov. ID
2) Permit (DTI/SEC/Business Permit)
3) BRGY.CLEARANCE
4) PNP/NBI CLEARANCE

Validated by: _________________________ Remarks:

MJ Decor Authorized Representative