International Distributor Inquiry Form

Become an International Distributor of BioCell Technology Branded Ingredients!

Thank you for your interest in BioCell Technology and our award winning branded ingredients. We are open to forming strategic partnerships with premier international distributors of dietary ingredients. If your company fits this description, please fill out the form below and a representative of BioCell Technology will contact you.

International Distributor Inquiry Form

Company

Title

Contact Name

Address 1

Address 2

City

State / Province

Country

Zip / Postal Code

Telephone Number

Email Address

Confirm Email *

Website Address

Regions Company Serves

How long has your company been in business?

Please give a brief description of your company

What other ingredients (US made) has your company distributed? :

My Company is interested in distributing the following BioCell Technology branded ingredients (please check all that apply):

BioCell Collagen

i-Sabi

EstraFlex CMO

How much (in kgs) do you expect to sell in the first (insert time period here)

How did you hear about us?

Additional Information

Attachments

International Distributor Inquiry Form