Vending Application | Vending Machine Manufacturer

Vendmax International Inc.
Confidential Application

You have three options to submit the Confidential Vending Distributor Application

1) Submit the below form which is sent directly to us.
2) You can also print off this Distributor application form and fax (204) 694-8700 to us.
3) Print the Distributor application form, scan and email to:

Take that first step, Apply now!

Be assured that the following information will be held in strict confidence and its sole purpose is to help determine the qualification of a Vendmax "Energiser Vending" Distributor.

This form does not obligate either party in any manner.

Date:	3/11/2010 1:36:06 AM
Name:
Address:
City:
State/Province:
Zip/Postal:
Country:
Business Phone:
Home Phone:
Cell Phone:
Best time to contact you:
Fax:
E-mail:
Age:
Marital Status:
Home:

Occupation:
Monthly Salary:
Years Employed:
Approximate Gross annual Household Income:
Are you eventually looking for a complete career change?
Who would run your business?
Amount available to invest:
Are you interested in our:
Do you plan to expand this business?

If this opportunity meets your needs and you are approved as a
Vendmax "Energiser Vending" Distributor, how soon could you start?

Please share any comments you feel may be helpful in assessing your application:

Personal Character References - other than employers or relatives:

Name in Full	Occupation	Phone	Years Known

Location Preferences: (By geographic area / city suburb / town-city)

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Vendmax International Inc. Confidential Application

Vendmax International Inc.
Confidential Application