DISTRIBUTOR PERSONAL DATA : Surname * Name * Sex * M F   Date of birth (dd/mm/yyyy) * Place of birth * State/Region * Nationality *   Address * City * ZIP/Post code * State/Region * Country *   Home phone * Mobile phone E-mail * Fax * Current  professional or business area* Geographical area covered by your current activity* Name of your most important customers/their industry Current company name Number of employees Current turn-over Suggested cooperation fields Suggested geographical area Expected turn-over Please type any hint or suggestion about your possible future role within our organization into the blank field below. Existing texts can be copied and pasted from other applications (i.e.Word or Excel). Mandatory fields*