Reseller Application Form

Company Information
Name:
VAT-number:
Invoicing address:
Delivery address:
Telephone:
Fax:
Year of foundation:
Number of employees:
Turnover/last fiscal year:
Contact Persons
Managing Director
Telephone:
Email:
Financial Director
Telephone:
Email:
Manufacturer
	Citrix Extreme Networks Fortinet McAfee NetApp Sun Microsystems Symantec Wyse Technology
Purchases/Credit Limit
Estimated purchases per year (EUR)VAT 0%
Requested credit limit (EUR)VAT 0%