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Please complete the following form to apply as an official Nevada Reseller. If you do not wish to apply online, you can download the PDF file and fax it to us. To download the PDF file, please click here.

Reseller Application Form
 
Company Information
* required fields
*Name:
*Address:
*Phone:
*E-mail:
*FAX:
*Year Founded:
Authorized Sales Agents:



Banking Information
*Accounts Payable Contact:
*Primary Bank Name:
*Branch:
*Telephone:
*Account No:
Vendor/Trade References
*Company Name:
*Phone:
*Address:
Company Name:
Phone:
Address:
General Information
How long has your company been in business?
What is your company's main business focus?
What is the size of your organization?(Choose one)
Less than 10 10-25 26-100
101-1000 +1000
In which industries do most of your clients operate?
What product lines does your company carry?
Which computer vendors do you deal with?
Does your company have a website? If yes, address?
Would you have concerns about listing that you carry our products? If yes, please explain.
Where did you hear about Nevada Learning Series?
Why do you want to carry Nevada Learning Series products?
Client References
*Company Name:
*Phone:
*Address:
Company Name:
Phone:
Address:
Company Name:
Phone:
Address:
 
 

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