Representation request

Name and surname*

First

Cell phone number*

Phone number*

With area code without spacing

Fax number

System name*

Type of business*

Store ownership

Store area

Stockroom ownership*

Stockroom area

Sale experience (year)

Brick sale experience (year)

Do you have a business license?

Which one are you interested in?

What companies and factories in the field of brick and non-brick did you have experience in working and representation?

Store address*

Street City State Postal code

Stockroom address

Street City State Postal code