ID Enquiry Form

INTERNATIONAL DISTRIBUTOR ENQUIRY FORM

This form, when submitted, will be sent to RescuEAN. On receipt, your request will be considered and you will be advised of our pricing structure, etc. If we mutually agree the terms then it is our intention (with the exception of larger Countries, i.e. USA/Canada) to only appoint one main Distributor.

Contact Email

Company Name

Telephone (including country code)

Company Address - Line 1

Company Address - Line 2

Company Address - Line 3

Website Address

Please give brief description of your business operation...

Countries/Territories you would like to be a Distributor for?

If you are in the USA, do you cover other States?

Please give an indication of the number of Retail/Dive School/Dive Club outlets you supply

Where did you hear about the RescuEAN Pod?

Contact Name

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