Service Request Form – Haalufa USA

Application Form - Business Expansion

Your Company's Information

Company Name

Authorized Person

Web Address

Phone Number

Country Pays

State / Province

City/Ville

Street Address

Zip Code / Code Postal

Nearest Trade Zone

Your Company's Sales Data:

Please enter you sales volume in USD for last, current and next year

last 2-years

Annual Sales $

Select Year

Annual Sales $

Select Year

Current Year

Annual Sales $

Select Year

Next Year

Annual Sales $

Select Year

What type of company?

Do you have a manufacturing facility?

What is your Industry?

Where are you currently selling?

How many employee do you have?

Do you sell through Broker/ Distributor?

Describe your products or service?

Secure Payment Options

Credit or Debit Card

Visa, MasterCard, American Express, Discover

Monthly Payments

Starting at $28/mo with

Pay with PayPal Nihahopay(Select this option to pay with Alipay, Union Pay, WeChat...)

Payment Amount

Please tick the checkbox as you are agree with the terms and conditions.

Service Terms & Conditions Payment Terms & Conditions

Service Terms & Conditions

TBD - Coming Soon!!!_Testing contents

Agree

Payment Terms & Conditions

TBD - Coming Soon!!!Testing contents

Agree

Data Retention Policy

TBD - Coming Soon!!!Testing contents

Agree

Application Form - Business Expansion

Your Company's Information

Your Company's Sales Data:

Please enter you sales volume in USD for last, current and next year

Service Terms & Conditions

Payment Terms & Conditions

Data Retention Policy

Secure Payment Options

Payment Amount

Service Terms & Conditions

Payment Terms & Conditions

Data Retention Policy