IOCELL Networks Reseller's Application
 
Online Application


PDF Application

 

  
Thank you for considering IOCELL Networks products for your company's distribution. If you would like more information about becoming a reseller, please complete the following form and after reviewing your application, we will contact you with necessary means to begin purchasing our products for resale. Alternatively, click here to download the pdf application and submit it via fax or by mail.
Primary Sales Contact

*Title:
*First Name:
*Last Name:  
*Principal/Owner:
*Main Phone:
 Alternate Phone:  
 Fax:
*Email Address:
 
Company Profile
 
*Company Name:
 *Doing Business as (DBA):
 *Address: Suite:
  Address 2:
 *City:
 *State/Province:
 *Zip/Postal Code:
 *Country:
 *Website:
 *Number of persons on staff:     Sales    Technical   
 Revenue:
 
Current Distribution Channels

Distributor Customer #
D&H
Ingram Micro
Tech Data
Synnex
 
Market Sector

*Market Scope: VAR or DMR:   Other:
*Primary Business: If other, please specify:
*Number of Outlets:
*Retail storefront? Yes No

*Vertical markets: (check all that apply)
Education Legal Enterprise Security
Government SMB Digital/Audio/Video SOHO
Hospitality Insurance Manufacturing  
Healthcare Other:  

*Storage Manufacturers Currently Offered: (check all that apply)
Iomega Lacie Simpletech
Mirra Maxtor Snap
Seagate Western Digital IOGear
Ximeta Buffalo Other:  

*Top selling storage product lines:
 
Credit Card Authorization (Required to order by email or phone)

Credit Card Type:  
Account Number:  
Expiration Date:  
Card Holder's Name:  
CCV2 #  


Credit Card Use Terms: I(We) agree to allow IOCELL Networks to use the credit card information listed for purchasing hardware and software ordered by . I(We) also understand that after this application is approved, a printed version must signed and returned by fax or by mail to IOCELL Networks. I(We) agree to allow this information to remain on file and be used for purchases until the expiration date listed here. I(We) will provide an updated authorization as needed and I(We) or IOCELL Networks may cancel this agreement at any time.

Check to accept credit card use terms.