Reseller Application form
Contact details
Company/Partnership/Sole trader name:
Represented by
Your position
Your primary business
Trading name (if different from above):
Street address:
City:
Zip/Post code:
VAT number
, please use the international format (example for the United Kingdom is UK123456789)
Alternative Business Address:
What is this address? (Register address etc.)
Telephone number:
(which will be listed on our website)
Fax number: (which will be listed on our website)
Internet contacts
At least one of the below email addresses must be associated with your website domain, such as
support@mywebsite.com,
and this email address will appear on our website.
General contact email:
Contact for invoice purposes:
License delivery email:
Technical support email: (default to appear on our website)
IP address (if fixed)
What kind of customers do you have?
SOHO
Small (up to 50)
Medium (up to 500)
Large (over 500)
Goverment, Education...
Do you have experience with technical support:
Yes
No
Technology/OEM Products
avast! AV engine for OEMs
OEM Partners
Business
Reseller program
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