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New Reseller Form
Note : All Fields marked with * are compulsory.
 
Primary Contact Information
 
*Company :

*First Name :

  Last Name :

*Address Line 1 :

  Address Line 2 :     

  Address Line 3 :

*City:

*Country :

*State/Region/Province :

*Zip/Postal Code :

*Phone No :
(Country Code - Phone Number)
Format should be 011-41512345678  

  Alternate Phone No :
(Country Code - Phone Number)
Format should be 011-41512345678

  Fax No. :
(Country Code - Phone Number)
Format should be 011-41512345678
 
Login Information
 
Your email address is used as your Username.
 
*Username :
(Email Address)
Please Enter Email Id as User Name

*Password :

*Confirm Password :
 
Finance Information
 
The field below is important. It represents the currency in which you maintain your books of accounts. Our system maintains all your transactions in dual currency. The system also calculates the Forex Fluctuation differences for each transaction incase your Accounting currency below is different from the Selling currency above.
 
*Accounting Currency :
 
Other Information
  
 
  Sales Representative :  

  Newsletter Subscription :  
     
Registration Verification
 
Note: By entering this code you can prevent spam and fake registrations. This code can be typed completely in lower case.
 
*Enter the code below:
 
 

 
I have read the Reseller Master Agreement , and I agree to all the terms therein.
     
   
 
 
  
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