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Reseller Registration Form
Reseller Registration Area
 
Welcome! We are ready to have you join us as a Reseller! Fill in ALL fields and press Save
 
Getting Started - Setup Your Reseller Profile
 
After entering your reseller profile information and then submitting it by pressing the Save button below, you will immediately be taken to a Contracts Acceptance page to accept the Reseller Agreement and other important legal documents. You may review all contracts before hand by clicking here. Please be aware, additional documents must be signed and returned to us for review before official activation of your reseller account. (* = required fields)
 First Name:
  * 
Reseller Package:
  Bronze (adjusted by admin later)
Last Name:
  * 
Affiliate Support:
 
Email:
  * 
Company Name:
 
Re-type Email:
  *  
Your Website URL:
 
Paypal ID:
  
Your Logo URL:
 
Phone:
  * 
Expire Date:
  2010-01-07 
Status:
   Pending Approval  
Balance Due:
   $0.00
Tax Id :
 *
Note: This is mandatory per IRS rules.		 
Amount Paid:
  $0.00
Address 1:
  * 
Notes for us:
 
Address 2:
 
 
City:
  * 
 
State/Province:
  * 
Mail Format Prefered:
 
Country:
  *    
Mail Code/ZIP:
  * 
Tax Witholdings Rate:
  % (see note 1 below)
Select a Password:
   *  
  Note 1: Foreign Reseller are required to allow withholding of 30% by IRS rules. Other resellers may option for our withholding and reporting as desired.
Retype the Password:
   *      
When you are satisfied with all your answers (please review and complete all fields carefully before submitting) press the Save button below when ready to save your reseller profile information. After pressing Save you will ultimately be taken to the Contracts Acceptance page. You must enter the challenge code below before pressing Save.
Challenge Code:
   6A18E723
Reenter Challenge:
  *
Save
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