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Reseller Application
Contact details
Company Name:
*
Suffix:
*
Mrs.
Mr.
Ms.
Dr.
First Name:
*
Last Name:
*
Business Address 1:
*
Business Address 2:
Phone number
*
:
E-mail Address:
*
How should Hectrix contact you?
*
E-mail
Phone
Either
Website:
Reseller
Business Nature:
*
Years in Business:
*
Select One
Less than a year
1-5 years
5-10 years
10-15 years
15-20 years
More than 20 years
Company Headquarters:
*
Company Size:
*
Select One
0-5
5-10
10-15
15-25
More than 25
Sales Team:
*
Select One
0-5
5-10
10-15
15-25
More than 25
Technical Team:
*
Select One
0-5
5-10
10-15
15-25
More than 25
Which product are you interested in representing?
*
ACTAtek - Access Control
ACTAtek - Time Attendance
LogiPrint - USB PC Fingerprint logon device
iAd - Signage Server
Annual Turnover:
*
Select One
USD 0-2 Million
USD 2-4 Million
USD 4-6 Million
USD 6-8 Million
USD 8-10 Million
More than USD 10 Million
Degree of Involvment:
*
Select One
Installation
Project Implementation
Technical Support
Software Application Development
System Integration
VAT Registration Number:
International Freight Carrier:
Comments / Feedback:
Where have you heard of Hectrix
*
:
Select One
Email / Promotional
Internet Search Engine
Exhibition
Newspaper / magazine
Others
If others, please be specific:
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ACTAtek Limited
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