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Distributor Details:
Name
*
First
Last
Email
*
Phone
*
Alternative Phone Number
Address
Product Request:
Select Products & Quantities (required):
Custard 2kg * 4 ₦20,000
Custard 50g * 100pcs ₦14,000
Mema Laundry Soap
Mema Liquid Soap
Quantity
Preferred Delivery Schedule (required):
Weekly
Monthly
On-demand
Business Information:
Target Market/Regions Served:
Business Type (required):
Wholesale
Retail
Both
Any Quantities Email
How long have you been in business?:
Location of Business
Payment Information:
Preferred Payment Method (required):
Bank Transfer
Cash
Others
Additional Information:
Any Special Requests or Notes:
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