Application form page skeleton.
[To be confirmed by company] Form implementation, CRM integration and anti-spam are pending.
Fields to be collected
| Field | Type | Required |
|---|---|---|
| Company name | text | yes |
| Country / region of registration | select | yes |
| Business licence or tax number | text | yes |
| Company website | url | no |
| Product lines of interest | multi-select | yes |
| Annual purchasing volume range | select | yes |
| Territory covered | text | yes |
| Warehouse capability | yes/no | yes |
| Installation services offered | yes/no | yes |
| Prior experience with comparable brands | textarea | no |
| Contact name, position, email, phone | text | yes |
What happens after submission
- Automatic acknowledgement within 60 seconds
- Qualification and territory-conflict review
- Follow-up call to confirm capability and volumes
Submit
Form embed placeholder – to be connected to the CRM.