Reseller Application Form

Simply fill in the details below and submit. Once we receive your application we will review it and be in contact with you within 3 business days to arrange a meeting with you to discuss the finer points of our partnership.

If you are unsure of any of the procedures or details, please contact Inology and we will endeavour to answer any questions you may have.

Reseller Details

A value is required. First Name:

A value is required. Last Name:

A value is required. Business Name: 

A value is required. ABN:

A value is required. Email Address:

Phone:

Mobile:

Residing Address:

Postal Address:

A value is required. Type of Business:

A value is required. Years in Business:

A value is required. No. of Employees:

A value is required. No. of Salespeople:

 

Vision / Mission Statement

Website Enquiry Details

A value is required. No. of Enquiries / Month:

A value is required. Geographical Areas of Enquiries (i.e. Gold Coast, Brisbane, Tweed Coast, etc.)

A value is required. Type of Businesses Enquiring (i.e. small, medium, corporate, government, if vertical market please specify)

A value is required. List Sources of Enquiries (i.e. Client Base, Own Website, Referral, Newspapers, etc.)

A value is required. Current Action on Enquiries (i.e. none, refer to / resell for another developer, in-house design, etc.)

Current Developer Referred / Resold for if applicable

Bank Account Details

(Referrers Only - For Commission Payments)

BSB  Account Number

Validate Form

A value is required. Please input validation code?:

 

A value is required. Required fields.