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We at Vinifera For Life are very interested in creating lasting relationships with new customers, distributors, franchisees and licensees alike which are of benefit to both parties.

However, due to the high volume of requests for information, we are unable to respond to each and every one. Therefore, we ask interested parties to complete the following form to help us better understand your proposal.

We sincerely thank you for your interest in Vinifera For Life and look forward to reviewing your proposal.

* denotes a required field

*Company or Personal Name:

*Year Established:

*Full Address:

*Email Address:

*Business Telephone:

Web Site: If Applicable:

Please Tell Us How You Found Out About Us:

Please Tell Us More About Your Business Including Whether It is Private or Publicly Held, Number of Locations, Number of Staff and Annual Sales:

What is the Added Value that You See From Your Firm Working with Vinifera For Life Based on your Current Understanding? What's In It For You?

What is the value-added that Vinifera For Life could expect from working with your firm? What's in it for Vinifera For Life?

How does Vinifera For Life fit in your corporate strategy and the nature of your business? Is Vinifera For Life central to some point of your business?

Thank you for completing the above questions. We will review your proposal and may have further questions at that time.