NetFreighters Australia :: OnLine Store

NetFreighters Australia

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Reseller Application Form

Company/Business Details		Please fill in or select the fields marked (*) with vaild data
Company/Business Name	*
Trading Name	*
ACN	*
ABN	*
Company Website	*
Email Address (to be used as your username. If you already have a Netfreighters' account, you can use same email address)	*
Telephone Number	*
Mobile Phone Number	*
Fascimile Number	*

Street Address
Address	*
Suburb	*
State
Postcode	*
Country

Postal Address		Same as above
Address	*
Suburb	*
State
Postcode	*
Country

Company Contact Details
Principal Contact Person - First Name	*
Principal Contact Person - Last Name	*
Title	*
Accounts Payable Contact	*
Sales Manager	*

Business Information
Years in Business	*
Geographic Area Covered by Sales	*
Other Antivirus Vendors Represented	*
Gross Sales - Antivirus Software (Last Year)	*
Total No of Staff	*
Will you be able to provide first level support for BitDefender?

Market Segments Focused on
Small to Medium (<500 users)
Large Business (>500 users)
Education
Government
Other

Platforms You Support
Windows (9x/Me/NT/2000/XP)
Linux
HP-UX
Solaris
Novell NetWare
Other

Online Ordering
Requested Password(If you are using existing Netfreighters' account, please enter same password.)	*

Payment Method (Strictly in Advance)

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