BIODATA MITRA DISTRIBUTOR No. Kemitraan : .........................1 Nama Lengkap : ........................................................................................................... No. Identitas (KTP/SIM) : ........................................................................................................... Tempat Tanggal Lahir : ............................................. No. Telp :............................................. Alamat Lengkap : ........................................................................................................... : ........................................................................................................... Alamat Usaha : ........................................................................................................... : ........................................................................................................... Wilayah Cakupan Usaha : 1. ............................................ 2. ..................................................... : 3. ............................................ 4. ..................................................... : Lainnya............................................................................................. Motivasi Bisnis : .......................................................................................................... Usaha yang sedang berjalan : .......................................................................................................... Daya Tampung Produk : .............Kg Motivasi Menjalin Kerjasama dengan Agro : ........................................................................................ ................................................................................................................................................................ Master Plan Pemasaran yang akan di jalankan : 1. ................................................... 2. ................................................... 3. ................................................... 1 Di Isi Oleh Pusat