Date *
:
COMPANY & ADDRESS
Company *
:
Company Registration Number *
:
Company Address *
:
City *
:
Province *
:
Telephone Number *
:
Fax Number
:
Website (http://)
:
BUSINESS DETAILS
Number of Employees *
:
Core Business *
:
Other services provided *
:
What other brand(s) do you sell now? *
:
Owner/ Decision Maker/ CEO *
:
Name : Designation :
Email : Mobile Number :
Primary Contact Person *
:
Name : Designation :
Email : Mobile Number :
Secondary Contact Person
:
Name : Designation :
Email Mobile Number :
Marketing Contact Person
:
Name : Designation :
Email : Mobile Number :
Finance Contact Person *
:
Name : Designation :
Email : Mobile Number :
Form Submitted by *
:
NOTE: The below email address will be receiving a copy of the submission info.
Email Address *
:
Your existing Top 10 customers that you would like to work with HTech
Note: Please input '0' if the field is not applicable.
Company Name 1 *
:
Company Name 1 Detail *
:
Location (Province) :    
Company Size : Users  
Products Sold :
PO/Revenue/year (USD) :    
Account Manager   Name Mobile Email
  :
Company Name 2 *
:
Company Name 2 Detail *
:
Location (Province) :    
Company Size : Users  
Products Sold :
PO/Revenue/year (USD) :    
Account Manager   Name Mobile Email
  :
Company Name 3 *
:
Company Name 3 Detail *
:
Location (Province) :    
Company Size : Users  
Products Sold :
PO/Revenue/year (USD) :    
Account Manager   Name Mobile Email
  :
Company Name 4 *
:
Company Name 4 Detail *
:
Location (Province) :    
Company Size : Users  
Products Sold :
PO/Revenue/year (USD) :    
Account Manager   Name Mobile Email
  :
Company Name 5 *
:
Company Name 5 Detail *
:
Location (Province) :    
Company Size : Users  
Products Sold :
PO/Revenue/year (USD) :    
Account Manager   Name Mobile Email
  :
Company Name 6 *
:
Company Name 6 Detail *
:
Location (Province) :    
Company Size : Users  
Products Sold :
PO/Revenue/year (USD) :    
Account Manager   Name Mobile Email
  :
Company Name 7 *
:
Company Name 7 Detail *
:
Location (Province) :    
Company Size : Users  
Products Sold :
PO/Revenue/year (USD) :    
Account Manager   Name Mobile Email
  :
Company Name 8 *
:
Company Name 8 Detail *
:
Location (Province) :    
Company Size : Users  
Products Sold :
PO/Revenue/year (USD) :    
Account Manager   Name Mobile Email
  :
Company Name 9 *
:
Company Name 9 Detail *
:
Location (Province) :    
Company Size : Users  
Products Sold :
PO/Revenue/year (USD) :    
Account Manager   Name Mobile Email
  :
Company Name 10 *
:
Company Name 10 Detail *
:
Location (Province) :    
Company Size : Users  
Products Sold :
PO/Revenue/year (USD) :    
Account Manager   Name Mobile Email
  :
Declarations *
:

Should you require further assistance, please email to sales@ht-dist.com and do not hesitate to contact us at +84 28 3911 1247 / +84 28 3911 1248 / WhatsApp/Zalo +84906724636.

Copyright © HTech Vietnam. All Rights Reserved.
Address:   Room RG-05.69, Floor 5, 151 - 155 Ben Van Don Street,
Ward 6, District 4, Ho Chi Minh City, Vietnam

Web:  www.ht-dist.com   Email: sales@ht-dist.com   Tel: +84 28 3911 1247 / +84 28 3911 1248