Product Demand Form for Distributors

Thank you for your interest in ordering our products.

Please fill out the form below with your name, email address, and the quantity of products you would like to order. If you have any issues filling out the form, please don't hesitate to contact us at 03075553283.

Please note that fields marked with an asterisk (*) are required.

Minimum order to be placed is 500 units

Name *

First

Last

Email *

Phone *

License NO:

NTN NO:

Address:

Address Line 1

Address Line 2

City

State / Province / Region

Please mention desired amount of the products below to join our team of successful distributors

AB Absorbent Cotton Roll (B.P.C) (( 50, 100, 200, 400, 500 ) Grams)

AB New Age Cohesive Bandage (5CM x 4.5M)

AB Gauze Roll (20M, 30M)

PAYMENT TERMS

50% at the time of payment.

50% before delivery

Other terms and conditions apply

Our representative will be in touch with you shortly to discuss the next steps after submitting the form.