Reseller Application
  To become a MGC Authorized Reseller, please fill out and submit the following form. This information remains confidential and will not be shared outside of MGC Technologies, Inc.
     
   
     
  GENERAL INFORMATION
 

Company Name: *
Reseller ID : *
Address : *
City : *
State : *
Zip Code : *
Contact Person : *
Title : *
Phone : *
Fax : *
E-Mail : *
Company URL : *
BUSINESS CLASSIFICATION
Reseller Distributor VAR System Integrator
OEM Wholesale Other
BUSINESS BACKGROUND
Year in Business :
Total Employees : *
Sales Employees :
Number of Sales Offices :
Address :
Do you have a showroom? Yes No
Target Market (Primary): Corp. Education Govt. Home Small Business
Target Market (Secondary): Corp. Education Govt. Home Small Business
Territory Focus : Local Regional National International
Annual Revenue : 1 Million 1-5 Million 5 Million +
On-Line Business Percentage :
PURCHASING INFORMATION
Do you currently sell MGC Display? Yes No
  Quantity Per Month?
What other brands do you sell?
How many displays do you currently
sell per month? 		14" 15"
17" 19"
  21 " LCD
What percentage do you sell with system :

How did you learn about MGC Partner Program? Publication Direct Mail Internet

Join Lead Referral Program? Yes No
Join our eNewsletter? Yes No

Thank you for taking the time to answer the above questions in this MGC Authorized Reseller Form.
Our Sales Representatives will contact you shortly.
Please note: Each field marked by an asterisk (*) must be completed in order for us to process your registration.


 
 
 
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