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Do you want to be a distributor?
Name of person or company *
Name or social reason *
Identity Card or RIF *
Fiscall address *
Phones *
email *
Web site *
Comercial activity *
Particular
Pharmacy
Supermarket
Distributor / drugstore
Wholesaler
Contact people *
Email *
Phone *
Trade Marketing actions to implement *
Danglers
Traffic breaks
Flyers
Floor Graphic
Pendon
Matchmaker
Displays
Other observations
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Política de privacidad
.
Atención:
Los campos marcados con
*
son obligatorios.
Attention:
Fields marked with
*
are mandatory