Distributor Application

Apply to become an authorized distributor of AAVAA’s cutting-edge technology. Join us in bringing innovative solutions in health and communication applications.

Primary Contact Information

First Name *

Last Name *

Title/Position *

Email Address *

Phone Number (If different from above)

Shipping Details (If different from above)

Warehouse Address (For shipping and receiving)

Country/Region

State/Province (If applicable)

City

Postal Code

Experience

Have you distributed assistive devices before? *

Yes

No

If yes, for how long? *

What types of assistive devices do you currently distribute? *

What is your target market for assistive devices? (e.g, healthcare facilities or individual consumers) *

Do you have a return policy for assistive devices? If yes, briefly describe: *

Financial Information

What is your estimated annual revenue from assistive device sales? *

What is the projected number of AAVAA devices you are looking to purchase? *

Compliance and Regulations

Are you familiar with the regulations governing assistive devices in your region? *

Yes

No

Collaboration/Partnership Goals

Which AAVAA Products are you interested in? (Check all that apply) *

Glasses

Headband

Headphones

Earbuds

How do you envision our products fitting into your current offerings? *

Additional Information

How did you hear about AAVAA Inc.? *

Please specify *

Is there anything else you would like to add? (Optional)

Thank you for applying to become a distributor for AAVAA. We’ve sent a confirmation email to you. A member of our sales team will be in touch within three business days. If you have any questions, feel free to reach out to info@aavaa.com

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Distributor Application

Distributor Application

Company Information

Primary Contact Information

Shipping Details (If different from above)

Experience

Financial Information

Compliance and Regulations

Collaboration/Partnership Goals

Additional Information

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