VIRGIN & VIRGO ASSOCIATES CLUB MEMBERSHIP APPLICATION FORM
1. NAME OF APPLICANT…………………………
2. REGISTERED ADDRESS IN NIGERIA………..
……………………………………………………
3.
4. COMPANY NAME………………………………
5.
6. COMPANY ADDRESS………………………….
……………………………………………………
TELEPHONE NUMBER………………………..
TYPE OF BUSINESS:
(i) DEPOT (ii) FILLING STATION
(iii) INDEPENDENT MARKETER
(iv) OTHER (PLEASE SPECIFY) ..
7. DO YOU HAVE A STORAGE FACILITY? YES / NO
IF YES SPECIFY CAPACITY
8. MINIMUM MONTHLY PURCHASE ORDER
(PLEASE SPECIFY IN 33,000 LTR TANKERS)
9. DO YOU WISH TO RECEIVE DAILY PRICE QUOTES FOR OUR PMS AND AGO PRODUCTS VIA SMS? YES / NO
(IF YES, THERE IS A CHARGE OF N1000/MONTH)
10. ANY COMMENTS / SPECIAL REQUIREMENTS