Dealer application form

Welcome to Behold.coffee,we take great care of our dealers / distributors and would love to have you onboard with us. Please fill the form below and let us get in touch with you within the next few working days.

Company Name:

This field is required.

Full Address:

This field is required.

Contact Person:

Please enter only alphabets (letters).

Contact Number:

Please enter 10-digit mobile number.

Contact Email:

Please enter a valid email (e.g., valid@gmail.com).

Office/Shop Size (sq ft):

Please enter a valid integer number.

Road Facing / Internal Facing:

Please select one option.

Passport Photo:

Photo of Shop (Near View):

Photo of Shop (Far View approx 100m):

Occupation Proof (Ownership Proof or Rent Agreement):

Cancelled Cheque:

DD of Rs 25,000:

Signed Contract Form:

CAPTCHA: