General Company Information

Company Name * Year Company Was Founded *

Are you able to provide a copy of your reseller certificate? *

Yes No

If you answered yes above, please upload reseller certificate here Headquarters Address * Number of Branches * Branch Locations * Number of Inside Sales Reps * Number of Outside Sales Reps *

Do you have a marketing team? *

Yes No

Do you offer special/custom product support to your customers? *

Yes No

Do you offer service and/or installation to your customers? *

Yes, we offer product servicing (maintenance, diagnosis, etc.) Yes, we offer installation service Yes, we offer both No, we do not offer service or installation

Website URL *

E-commerce *

Yes No

Main Industry of Sales * Desired Payment Terms *

Main Contacts (Name/Email/Phone Number)

Sales Manager's Name * Sales Manager's Email * Sales Manager's Phone Number * General Sales Contact Name * General Sales Contact Email * General Sales Contact Phone Number * Accounts Payable Contact Name * Accounts Payable Contact Email * Accounts Payable Contact Phone Number * Marketing Manager's Name (N/A if you do not have a marketing team) * Marketing Manager's Email (N/A if you do not have a marketing team) * Marketing Manager's Phone Number (N/A if you do not have a marketing team) * Misc