››  Distribution Information

Thank you for your interest in becoming a distributor of our products.

We are currently seeking general distributors in certain regions of the world to promote and sell our products, and we are always open for new marketing ideas.

Currently we are working with NetChain Communications to develop online tools to help you incorporate the distribution of our products into your existing web site. Soon you will be able to fulfill your orders automatically, by connecting your web site with our services via various SOAP or XML protocols. Depending on your level of expertise and the resources available to you, you will be able to choose from something as simple as adding a button to your web site, to a complete automation of ordering procedures, similar to those used by the industry leaders such as Amazon, PayPal, eBay, Tiger Direct, etc, but in the mean time we are doing business the old fashion way.

Please fill out the following application if you are interested in becoming a distributor for CarePluss Pharma. Upon review of your application, the Sales Manager will contact you with more information. Thank you for your interest in CarePluss Pharma.

Distributor's Application
Required fields are marked with asterisk (*)
First Name:	*
Last Name:	*
Email Address:	*
Phone Number:	*
Company Name:
Address:	*
City:	*
State or Province:	*
Zip or Postal Code:	*
Country:	*
Information about your business
Your web site address:
How did you hear about us:	Click to selectFound via Search EngineHeard a comercial on the radio or TVSaw an ad in a magazine or newspaperSaw online advertisementWord of mouthOther
Your primary industry:	Click to selectBeautyCosmetology Products or ServicesCulture & ReligionEntertainmentFood, Drink & NutritionGeneral BusinessGiftsInternet & Hi-Tech Services or ProductsMedical & PharmaceuticalMedical Products or ServicesNon-Profit, Political & ReligionOnline SalesPharmaceutical Products or ServicesRetail OutletService ProviderOther*
The structure of your organization:	Click to selectCorporationLimited Liability CompanyNon-Profit CorporationPartnershipSole ProprietorshipOther
Type of your business:	Click to selectDistribution CenterMail Order HouseMedical ClinicOnline StoreRetail OutletService ProviderOther*
Annual gross from sales:	Less than $10,000$10,000 - $100,000$100,000 - 1 millionMore than 1 million
Number of employees:	Click to select1 to 56 to 1010 to 50More than 50
How are you planning to sell our products:( check all that apply )	Physicians Aesthetic Practitioners Online - on my web site only Online - on the web sites of my partners Retail Outlet Mail order catalog Distribute to other resellers Other
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