Reseller Application

  Please complete this form,
  Alternatively or 086 727 2345 (Office Hours)

Fields marked with an * are compulsory.


Anticipated Number of Users you will sign up in the:
First Month *
 
3 Months *
 
12 Months *
 
First Name *
 
Last Name *
 
Company name (or Sole Trader)
 
Industry of Current business activities
 
Position in your company
 
Main SA City of operation
 
Mobile Number: *
 
Email Address *
 
Website
 


Please note that you will within 1 business day set up a test agency for you such that you will have access to the relevant documentation under the downloads section.

Please accept any "Invitation" to join or "Welcome" mail which will carry your username and password to have access to the system.

Please note that should you agree to continue as an agent then your commissions will be paid out back dated to today.

Commissions are discussed in "Revised Agency Agreement" (Appendix A) as can be found in the download section once you have logged in.

I have read the NDA and agree to the terms and conditions of use.


 

All contact information is considered private and confidential and will not be used in any way other than the intended purpose of this contact form.

 

 


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