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SALES AGENTS

Please provide the following information.
(All information submitted will remain confidential):

Name:
Company Name:
Address:
City:
Province:
Country:
Phone:
Email Address:
                             Area of Operation:

Number of Years in Business:
Total Number of Employees:
Number of Sales Personnel:
Number of Engineering Staff:
Plastic Injection Molding Experience:
Other Companies Represented:
Is your administrative staff experienced with import procedures in your country? Yes    No
Are you familiar with Orycon's competitor's
in your country?
Are you familiar with users of the type of products manufactured by Orycon?
Are you familiar with mold making companies in your country?
Are you familiar with Plastic Injection Molding companies in your country?
Do you or someone in your organization speak English?
What other languages are spoken in your company?
Best time for telephone contact?