APPLICATION FORM

RESELLER APPLICATION FORM

Information about the company and the main contact person required for the reseller account in the Business Shop:

Field Name
Your Data


Company Name

Main Street

Main Additional

Main Postal Code

Main City

Main Country



Billing Street

Billing Additional

Billing Postal Code

Billing City

Billing Country



Company Website

Business Registration Number

Tax ID (if available)

VAT ID (for European companies only)



Main Contact First Name

Main Contact Last Name

Main Contact Telephone

Main Contact Fax

Main Contact Email



Notification Email
(Used for all automatically generated emails like invoices, order confirmations, etc.)


Information for the first user that will be created with the reseller account:

Field Name
Your Data


First Name

Last Name

Email

Login
(must have between 8 and 30 characters,
a-z, A-Z, 0-9)

Password
(must have between 8 and 30 characters,
a-z, A-Z, 0-9)


Public information for customers, fields marked with an asterisk are optional:

Field Name
Your Data


Company Name

Company Website *

Customer Support Email *

Customer Support Phone *

Company Address *

Countries Served *

Contact Person *