BALAJI WAFERS PRIVATE LIMITED

Vajdi (Vad), Kalawad Road, Ta. Lodhika, Dist. : Rajkot, Gujarat (INDIA). Phone : +91-7069014141

website : www.balajiwafears.com, E-mail : contact@balajiwafers.com

New dealer inquiry form

Fill this form in Capital Letters only*
Ref. No:- Date*
(1). Firm Name : -
(2). Contact Person Full Name*: -
(3). Town*:- District*:-
(4). Sate*:- Pin Code*:-
(5). Business address :-

(6). Residential address*:-

(7). Your Town Population :- No. of shop :-

(8). Phone number* :- Phone number :-

(9). Present Business Information :-

Monthly Turnover in
Company Name Type of Business Products Name Lacs

Total Investment in RS in Lacs.*:- Own:- Borrow:- Total*:-

(11). Reasons For interested in our business :-
(12). Infrastructure Available :

Commercial Vehicles :- 3 Wheeler:- 4 Wheeler:- Total Vehicles :-

Manpower :- Self:- Salaries:- Total Manpower:-

(13). When you ready to start ? Date:- Warehouse in (sq.m.) :-
(14). Family Background*:-
Father's Full Name* :- Occupation*:-
Brother's Full Name :- Occupation :-
(15). Other information :-

Filled by Company Staff

Name* :- Applicant Name* :-
Sign* :- Sign* :-
Experience
in Years