Partner Program

Introduction
Channel partner
Affiliate Partner
Sign up as a partner

  Business Details
 
Please choose:     Channel Partner   Affiliate Partner*
 
Trading name of business  
 * 		Registered name of business  
 *
Business Reg. No. of Incorporation  
* 		VAT Registration number  
*
Date of establishment of business  
*
* Please complete
 
  Business Activities
 
Contacts person's name  
* 		E-Mail  
*
 
  Postal address same as Physical
Physical Address  
*		 Postal Address  
*
Area Code  
* 		Area Code  
*
 
Tel Area code and no.  
* 		Fax Area code and no.  
*
Cell no.  
*
* Please complete
 
  DETAILS OF : Proprietors / Directors / Members / Partners
 
Full Name:  
* 		ID No. (or date of birth)
*
Residential Address  
*
Area Code  
 
Full Name (2nd):  
* 		ID No. (or date of birth)
*
Residential Address  
*
Area Code  
* Please complete
 
 Bank Account Details
 
Bank :
Account Name
* IE: J Smith
Branch
 Account No
*
Branch Code
*		 Account Type
* Please complete
 
 Trade References
 
Company Name:  
* 		Tel Area code and no.  
*
Physical Address  
*
Area Code  
 
Company Name (2nd):  
* 		Tel Area code and no.  
*
Physical Address  
*
Area Code  
* Please complete
 
 Please select which products/services you wish to resell:
Hosting
Linux Web hosting
Windows Web hosting
Virtual Servers
Colocation
Dedicated Servers
RSAWEB Online Backup
Zimbra
 Connectivity:
Business ADSL
Super/Ultra/Premium DSL
HSDPA
iBurst

 Confirmation


* The undersigned confirms that : 1.)The accuracy of the information is true and correct. 2.) They are duly authorised to enter into agreements for/on behalf of the applicant. 3.) They have read and understood the terms and conditions of trade and accept them as binding on behalf of the applicant.
 

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