DSM Industries Trichy - Distribution Enquiry Form

DSM Industries Trichy, is very interested in partnering with you to provide world class products and services to customers. We would like to take this opportunity to know more about your current business and experience as a sales/distribution channel.

Your Name (Required)
Company Name (Required)
Street Address (Required)
City (Required)
State/Province (Required)
PIN/Zip/Postal Code (Required)
Country (if outside India)
Phone Number (Required)
Fax Number
Email Address (Required)

Please tell us about your company and your business model. Help us understand why you are well-suited to distribute DSMIT® products in your area.

Please indicate the products which you are interested in distributing:

	DSMIT Pumps Division Deep Well Hand Pumps India Mark II India Mark III DSMIT® Mark IIx EZ-PackTM DSMIT® Mark IIIx EZ-PackTM DSMIT® India Mark II pumps with membrane filter DSMIT® India Mark III pumps with membrane filter
	DSMIT Intensive Care Unit Furniture Emergency Room Hi-Lo Beds. Other Hospital Furniture (please enter specific item(s) you are interested in)
	DSMIT Automobile Components Division U-Bolts for Auto Applications U-Clamps for any general purpose use (any size) Hi-Tensile Alloy Steel and Stainless Steel Fasteners Thread Rolled Fasteners (custom made to customer requirements) If you have any special requirement, please let us know
	Special Requests or Comments? If there is anything missing in this form that you are specifically interested in, please write down the details here.

DSM Industries Trichy - Distribution Enquiry Form

Your Name (Required)

Company Name (Required)

Street Address (Required)

City (Required)

State/Province (Required)

PIN/Zip/Postal Code (Required)

Country (if outside India)

Phone Number (Required)

Fax Number

Email Address (Required)