Kara Water Partnership Form

1

Let's Begin! Click "Next"

2

Name* This field is required.

First Name

Last Name

3

Email* This field is required.

example@example.com

Email Verified

Confirm Email

Email Verified

The verification code has been sent to some@email.com
Please check your mailbox and paste the code below to complete verification

••••

4

Phone Number* This field is required.

Country Code

Area Code

Phone Number

5

PositionIf "Other" please elaborate at the end of the form

Buyer

Executive

Sales

Other

6

Which territories do you operate in?* This field is required.Select all that apply

7

What product are you interested in, Kara Pure, Kara Pod, or both? (select all that apply)* This field is required.Kara Pure = 10L / day standing model Kara Pod = 3.2L / day countertop model with coffee pod feature

Kara Pure ($4899)

Kara Pod ($599)

8

Please indicate which type of partnership you are interested in.* This field is required.

If "Other" please elaborate. If not applicable type "N/A"

9

Do you provide servicing?* This field is required.

YESNO

10

What is your annual revenue?* This field is required.

11

How many years have you been in operation?* This field is required.

12

What type of products do you currently offer?* This field is required.If none, please elaborate

13

Company website* This field is required.

14

Wholesale pricing becomes available at an MOQ of 6 units for Kara Pure and 24 units for Kara Pod. Do you accept these terms?* This field is required.If "no" please elaborate at the end of the survey

YESNO

15

How did you hear about us?* This field is required.

If "Referred by someone" please provide their name. If not applicable type "N/A".

If "Other" please tell us where you heard about us. If not applicable type "N/A"

16

Is there anything else that you'd like to share with us?Final Question

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Please verify that you are human* This field is required.