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New Dealer Application

SALES MANAGER , SCOTT HARRIS, LEADS A MEETING OUT AT THE FIELDS.

NEW DEALER APPLICATION

Your Name:

Legal Name of Entity Dealer Products:

Street Address:

Mailing Address (if different than street address):

Phone Number:

Fax Number:

Web Address:

Email Address:

Syngenta Tech Number:

Number of Current Salespeople:

Years in Business:

Do you have access to storage facilities?:

Do you have any pending lawsuits against you or your company? If so, please explain.:

Have you dealt any other seed brands? If yes, please list.:

How many bags of seed corn do you currently sell?:

Why are you interested in carrying Masters Choice?: