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AGENCY/REPRESENTATION FORM:
Would you like us to Represent your company in Nigeria and West Africa or would you want to represent us in your Location?
COMPANY NAME:
YEAR ESTABLISHED:
EMAIL ADDRESS:
ADDRESS:
WEBSITE:
CONTACT PERSON:
POSITION:
TELEPHONE No.
FAX:
NATURE OF BUSINESS:
CAPITAL BASE:
PREVIOUS REPRESENTATION:
YES
NO
ARE YOU REPRESENTED IN ANY W/AFRICAN COUNTRY?
YES
NO
