Red Labs Distributor Application Form

Become a proud distributor of Red Labs Bioscience Pvt. Ltd.

Personal Details

Full Name:

Mobile Number:

Alternate Number:

Email Address:

Business Details

Firm/Company Name:

GST Number:

Drug License Number:

Firm Type: Proprietorship Partnership Pvt Ltd Other

Years of Experience:

Address Details

Complete Business Address:

City: State: Pincode:

Coverage Area

Which area(s) or district(s) do you want to cover?

Infrastructure & Facilities

Do you have a godown/warehouse? Yes No

Storage Space Size:

Delivery Team/Logistics? Yes No

Current Distribution

Currently distributing any pharma brands? Yes No

If yes, list them:

Monthly Sales Volume:

Why do you want to join Red Labs?

Investment Interest

Are you ready to invest in stock & distribution setup? Yes No

Upload Documents

GST Certificate:

Drug License:

Aadhaar/PAN:

Declaration

I declare that the above information is true & correct.

Signature (Type Full Name):

Date:

Submit Application