COTOPIA — Distributor Application

🔵 Section 1 — Contact Information

Full Legal Name

Preferred Name

Email Address

Phone Number

Company Name (if applicable)

Business Address

City / State / ZIP

Country

🔵 Section 2 — Business Profile

1. How did you hear about Cotopia?

Social Media Referral Advertisement Other:

2. Have you ever worked as a distributor, affiliate, or sales representative?

Yes No

If yes, please describe briefly

3. What interests you most about the Cotopia distributor program?

Residual income Exclusive product access Marketing & branding support Building a team Other:

4. What is your estimated monthly time commitment?

5–10 hrs/week 10–20 hrs/week 20+ hrs/week

🔵 Section 3 — Operations & Readiness

5. Do you already manage any online sales channels?

6. Do you have experience with (select all that apply)

7. Do you plan to build a team under you (sub-distributors)?

Yes No Maybe later

🔵 Section 4 — Compliance & Eligibility

8. Are you willing to sign our NDA and EULA before receiving access to Cotopia systems?

Yes No

9. Are you legally eligible to operate as an independent distributor in your location?

Yes No

10. Do you understand that Cotopia is an exclusive, invitation-only distributor network?

Yes No

🔵 Section 5 — Payment & Activation Preparation

11. Are you prepared to submit the activation payment after onboarding acceptance? (This is not a payment form — confirms readiness)

Yes No

12. Do you understand you will receive the following in sequence?

✔ Intro Kit → NDA/EULA
✔ Onboarding Kit → Master Partner Agreement + Exhibits + Tax Docs
✔ Brand Assets Kit → Products, flyers, templates, posting guides
✔ Ongoing training + backend support

Yes No

🔵 Section 6 — Final Confirmation

13. Why do you believe you are a strong fit for Cotopia’s distributor network?

Digital Signature

Date