Agent Application Form

AGENT APPLICATION FORM
Becoming a Melita Agent is almost as easy as filling in this form and answering a few questions. If successful you will be representing Melita and we are very keen to make sure that we join with the right people around the world. Just as you expect to have excellent commitment, support and quality products from Melita, we also want agents with the right vision, passion and commitment representing the brand.

If this sounds like you, then you are well on your way to earning good commissions for any honey sold and joining the great team environment we have at Melita.
ABOUT YOU
Full Name*

First NameLast Name
E-mail*
Phone Number*

Country CodeArea CodePhone Number
Are you an agent for any other products or companies*

YesNo
Please provide further details of the products or companies you are an agent for

ABOUT YOUR ORGANISATION
Company Name
Company Website URL
Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Country CodeArea CodePhone Number
Briefly describe the primary business of your company
How long has your company been acting as an agent for other products
What are your current sales channels?
Which media (eg. publications, social media, tv, etc...) do you currently use for advertising and promotions?
Do you employ any staff?

YesNo
How many staff do you currently employ
How would your rate your current understanding of the Manuka honey industry?
How would you rate your current sales knowledge of Manuka honey?

YOUR PLANS AS AN AGENT
Do you intend to sell or promote Melita products online?*

YesNo
Describe in more detail how you intend to sell or promote online
Which cities / regions / countries do you intend to promote and sell Melita products*
Briefly describe why Melita should consider you as an agent?*
If you have any documentation that you would like to supply in support of your application please upload it here
Should be Empty:

AGENT APPLICATION FORM