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    Name *
    Title*
    Business name*
    Adress*
    Email*
    Phone Number*
    Website*
    Write a label for How did you hear about TinhBotXanh*
    Received an emailFacebookInstagramGoogle searchReferralArticleContacted by sales representativeAmazon
    Requested Territory *
    List the types of customers you serve and different distribution channels you use *
    Who are your largest competitors, how you do you rank in size, and what are competitive the differences? *
    What products do you presently distribute?
    Annual Sales Volume - USD *
    $0 - $500,000$500,000 - $1,000,000$1,000,000 - $5,000,000$5,000,000
    Are you familiar with all the customs and tax regulations pertaining to the territory?
    0 - 1010 - 5050 - 100100+
    Number of Employees *
    YesNo
    Is your marketing department in house? *
    YesNo
    Do you have your own resources for translating and adapting basic marketing materials such as literature for your own markets? *
    YesNo