TSEFS Reseller Sign-up Form

TSEFS Reseller Sign-up Form

To sign up as a TSEFS Reseller, please complete the form below.

Name and Address

Company:
Salutation:
First Name:	*Please enter a value for this field.
Last Name:	*Please enter a value for this field.
Address Line 1:	*Please enter a value for this field.
Address Line 2:
City / Township:	*Please enter a value for this field.
State / Province:	*Please enter a value for this field.
Zip / Postal Code:	*Please enter a value for this field.
Country:	*Please enter a value for this field.
BN / VAT ID:	*Please enter your Business Number (Canada) or Value Added Tax (VAT) Number.
Phone Number:	*Please enter a valid phone number.
Fax Number:	*Please enter a valid fax number.

E-mail Address

The e-mail address entered below will be used to contact you and to forward important TSEFS Reseller information, so please ensure that you enter it correctly. We ask that you enter your e-mail address twice, to ensure accuracy.

E-mail Address:	*Please enter a valid email address.
Confirm E-mail:
Website:

Type Of Industry You Serve

Industry Type:

If you selected "Other", please specify:

* Please enter a value for the "Other" field

General Information / Comments

To help us understand you better and to streamline which type of TSEFS Reseller information to send to you, please feel at ease to provide any futher information or comments that you think might be useful.

General Info. / Comments: