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ANEXO Nº 6

REGISTRATION FORM FOR INTERNATIONAL BUYERS

  1. EVENT INFORMATION (To be filledoutby PROMPERÚ)

1.1.Event / Centro Exporta 2017
1.2.Place and date / City / Country / Start date / Finish date
Huanuco / Peru / 12 / 07 / 2017 / 13 / 07 / 2017
  1. COMPANY INFORMATION

2.1.Company name
2.2.Trade name
2.3.Phone(s)
2.4.Address / 2.5.Postal Code
2.6.City / 2.7.Country
2.8.Website / 2.9.Fax
  1. CONTACT INFORMATION AND REPRESENTATIVES

3.1.Contactname (person who workas the coordinator or focal point of information concerningan event)
Full name / Position at the Company / Type and number of ID Document / E-mail / Phone
( ) Passport: ______
( ) Alien registration card: ______
( ) Passport: ______
( ) Alien registration card: ______
3.2.Representatives (person who will attend the event)
Full name / Position at the Company / Type and number of ID Document / E-mail / Phone
( ) Passport: ______
( ) Alien registration card: ______
( ) Passport: ______
( ) Alien registration card: ______
  1. COMPANY PROFILE(Mark with an X)

4.1.Date of Establishment / 4.2.Number of employees
4.3.Annual sales (USD)
(Lastyear) / 4.4.Annualimports (USD)
(Lastyear)
4.5.Type of business / ( ) / Importer / ( ) / Manufacturer / Producer
( ) / Distributor / ( ) / Broker (Sales Agent)
( ) / Supermarket / ( ) / Wholesaler
( ) / Retailer / ( ) / Others (Specify): ______
4.6.Company industry / ( ) / Agribusiness / ( ) / Fisheryproducts
( ) / Miscellaneousmanufacturing / ( ) / Services
( ) / Apparel and home decor (Including giftware) / ( ) / Others (Specify): ______
4.7.Productsyouoffer / Productdescription / Productinformation / Certifications
(Biotrade, fairtrade, etc.)
(Add as many rows as necessary)
4.8.Geographicscope / ( ) / City / ( ) / Domestic / ( ) / Regional / ( ) / International
  1. INFORMATION FOR YOUR PARTICIPATION AT THE EVENT (Mark with an X)
(If your company wants to buy Services, you must complete the Appendix A also)
5.1.Is it your first time at this event? / ( ) Yes ( ) No, If not, please tell us:
How many times have you participated in events with PROMPERÚ: ______
5.2.Have you tried to buy goods or services from the Peruvian market before? / ( ) Yes ( ) No, If so, please tell us how:
How did you getincontact with Peruvian companies?
( ) Business trip ( ) Market research ( ) Internet ( ) Others (Specify): ______
5.3.Indicate goods / services you bought
(Pleasedetail)
5.4.Indicate which products you are interested in purchasing(Please detail) / Productdescription / Productinformation / Certifications
(Biotrade, fairtrade, etc.)
(Add as rows as necessary)
5.5.Are you interested in meeting with some specific company? / ( ) Yes ( ) No If so, please complete below:
Company name / Contactperson / Phone / E-mail
  1. ADDITIONAL INFORMATION(Mark with an X)

6.1.How did you hear about this event? / ( ) PROMPERU ( ) Peru Trade Office at ______
( ) Others (Specify): ______
  1. IMPORTANT NOTICE

  • PROMPERU will notify the evaluation results to the email address from number 3.1. Ifyour company is admitted, you will receive attached to this notification, the business agenda or visit agenda.
Participant obligations
  • Attend business meetings in the date and time scheduled.
  • Provide Buyers Survey properly filled out after the event, if required.

Stamp and legally binding signature
Date: _____/_____/_____

FO-PRO-033 V.01

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  1. COMPANY EVALUATION (For PROMPERÚ use ONLY)

8.1.Do you agree proceedingwith the registration? / ( ) Yes ( ) No / 8.2.Evaluation date: / / /
8.3.What were the reasons for choosing this potential buyer?
a)
b)
c)
8.4.Comments:
Evaluatedby: / Approvedby:
Signature
Full name: ______
Position at thecompany: ______
Date: _____ /_____ /______/ Signature
Full name: ______
Position at thecompany: ______
Date: _____ /_____ /______

FO-PRO-033 V.01