DTH Channel Partner Application Form HELP

General Information

    Are you an existing Reliance ADAG Channel Partner ?* Yes    No
    From which source you came to know about this portal ?
    Are you already dealing with other DTH companies such as Tata Sky, DISH TV, etc. ?* Yes    No
    Are you related to any of Reliance BIG TV employees ? Yes    No

Login Details

    Password:
    Re-Confirm Password::
    E-mail Id:
PREFERRED TERRITORY INFORMATION
    Preferred Circle
    Preferred Cluster
    Preferred Town
    Preferred Type Of Channel Partner

PERSONAL INFORMATION

  I. Name of Applicant: (Name of Firm)
Addresss
Telephone / Mobile:
Fax:
 

BUSINESS INFORMATION

  I. TYPE OF FIRM                    
II. Name(s) of Proprietor/Partner(s)/Managing Director(s)   :
  DETAILS OF THE OWNERS / PROMOTERS OF THE FIRM / COMPANY:


Sl. No

Name

Designation

Age

Qualification

% share

Involvement in the firm/Co.

1.
2.
3.


III. BUSINESS HISTORY
  Details of Present Business   :


Sl. No.

Name of Firm

Name of Company dealt with

Geography

Since the year

Product Group

Annual Gross Turnover Rs.

No. of Retailers covered, if any

1.
2.
3.
Details of Past Business   :


Sl. No.

Name of Firm

Name of Company dealt with

Geography

Since the year

Product Group

Annual Gross Turnover Rs.

No. of Retailers covered, if any

1.
2.
3.
IV. OPERATIONAL DETAILS:
  (A) Details of Present Managerial & Sales Staff (not relatives):


Sl. No

Name

Position

Qualification

Experience

Responsibility

1.
2.
3.
4.

(B) Details of Present Infrastructure:

1.
No. of Delivery Vans/Vehicles:
2.
No. of PCs :
3.
Availability of Internet Connection : 
4.
Office Space (In sq. ft.):
5.
No. of Godowns & Storage Space (In Sq. ft.):
6.
No. of Telephone Lines :
7.
No. of Telecallers :
8.
No. of Two Wheeler:

PROPOSED PLAN FOR BIG TV DTH BUSINESS

  I. MANPOWER :
 

The number of sales personnel for successfully running the DTH business would depend upon the potential of the market, and hence, would change from time to time. Based on your initial discussion, please indicate the number of persons to be on-board at the time of start of operation.

TYPE

NUMBER

FOS

TELECALLERS

II. INFRASTRUCTURE :
 
1.
Total Space (INCL. STORAGE)(In Sq. ft.):
2.
No. of Telephones :
3.
No. of PCs :
4.
INTERNET CONNECTION : 
5.
DELIVERY VAN :
III. FINANCIALS
 
1.
INITIAL INVESTMENT FOR DTH BUSINESS( INCL. DEPOSIT) is Rs. :

BANK NAME

BRANCH

ADDRESS

O/D FACILITY AVAILABLE



(Please enclose photocopies of suitable supporting letters from your bankers.)

OTHER INFORMATION

  I. SALES & SERVICE TAX REGISTRATION NUMBERS:
 
State.R.S.T. No   Dated: (DD/MM/YYYY)
C.S.T. No          Dated: (DD/MM/YYYY)
Service Tax No Dated: (DD/MM/YYYY)
VAT No              Dated: (DD/MM/YYYY)


(Please enclose photocopies of both the certificates)

I / we hereby certify that the information given in the application form is correct and complete.


I / we hereby certify that if selected as Reliance BIG TV Channel Partner, I / we will terminate our association with other DTH companies like DISH TV, TATA SKY, BHARTI DTH , SUN DIRECT, etc.

I / We agree to accept that the information given in the application form will be the basis of the dealership agreement, if entered into, between our respective organizations, and that if, at any time, I / we are found to have concealed any material information or given false details our dealership would be subject to termination without notice, and further that this would be without prejudice to our rights under the agreement. I / We agree to accept that the application shall be evaluated against various criteria and the company reserves the right to reject any application without assigning any reason.

Signature of Proprietor/Partner(s)/Authorised Person/Managing Director and Seal of the Firm

Name:
Date:
Place: