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Reseller application form

  Available Reseller Packages:

  Reseller Package 1 - Total Cost $120.
 
New Reseller Package with Private Branding, and ability to set your own rates. Includes New Reseller Introductory package with $20 worth  of International
  Long Distance call credit, which can be shared among Unlimited Virtual Numbers.

  Reseller Package 2 - Total Cost $299 + Shipping Fees if applicable.   Comes with a Linksys SPA941 internet phone, private branding and ability to set your own rates. Includes $30 worth of
  International Long Distance, which can be shared among Unlimited Virtual Numbers.

 
Fill the form below as appropriate. Note that the fields marked * are manadatory.
 

Reseller Package 1 (USD 120)
   
 
Reseller Package 2 (USD 299)
 
*First Name of the Individual Responsible:
 
 
*Last Name of the Individual Responsible:
 
*Company Name:
 
Web Site Domain Name:
 
Note: Leave this field blank if you do not have a domain name.
   
*Primary Email Address:
 
Note: If you use a free email service like Hotmail, Yahoo, Gmail,
you must supply a secondary email address, with your ISP
*Confirm Primary Email Address:
 
*Secondary Email Account:
 
*Account Address:
 
 
 
*Account City:
 
*Account State/Prov:
 
*Account Postal Code:
 
*Account Country:
 
*Telephone Number
( Country code - Area code - Phone number):
      
You may be given a call at this number to verify and complete this order.
Fax Number:
*Payment Method:
 
*Please select a 7 digit virtual number:
 
*Password (Min 6 characters):
 
Referred By:
Your comment:

  Agreement term
I, the RESELLER, agree that I am responsible for all orders and payments made in my reseller account. I may, from time to time, use third party credit cards, my own credit cards or paypal to make payments on my orders and I agree to be fully responsible for those payments in case of chargebacks or errors
 
     

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voIPKenya P.O Box 522 Karen, Nairobi - KENYA
 

 

 

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