Privi Life Sciences is rapidly expanding its distribution network and is looking out for channel partners to partner in our growth. If you / your business has experience and knowledge of distribution and channel operation in the Agri-input products vertical (fertilizers, pesticides, fungicides, seeds, crop supplements and nutrients, farming and agriculture equipment) we would be happy to hear from you.

Please complete the form with all required details and we shall be in touch with you on the approval and confirmation process. This is a first level registration process and based on your inputs there may be several levels of information, verifications and due diligence required to complete the entire process if your experience, skills and offering are in line with our business requirements

Yes
No
Name of Partner / Directors / Proprietors Address Contact No
Name of Bank Branch Name Address of Bank
License Details Number Date of issue Date of Expiry
Fertilizer License No :
Insecticide License No :
GST No :
Name of the Company Type(Retailer/Distributor) Area Since Sales Turnover
Product Sales Last Year Previous Year
Fertilizers/Micro nutriments
Pesticides/Fungicides/Others
PGR'S
Name of Company Tehsil of Operation No. of Sub dealers
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