Reseller Application: Stage 1

Company Information:
Company Name * Please state the full trading name of the company.
Address: Line 1 *
Address: Line 2
Town / City *
Post Code *
Country
Company Telephone *
Company Fax
Company Website
Vat Number
Company Legal Status * e.g. Sole Proprietorship, PLC, LTD etc.
Nature of Business e.g. VAR, e-tailer, reseller, distributor etc.

Personal Information:
Title
First Name *
Last Name *
Position in Company
Direct Telephone Number *
Mobile Number *
Direct Email Address *
Verify Letters *
Submit Form
Please verify that all the above information is correct. Once submitted, a member of Hazro's Partnership team will contact you with further instructions on how to access the reseller portal.