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RESELLER APPLICATION Print format version of this page

Step 1: If you are in the United States, fax a copy of your state resale tax certificate to
425-644-8222, attention "Sales Department."
Step 2: Complete this form and submit it using the "Submit" button at the bottom.

You will be contacted by an UltraBac Software sales representative within two business days.

Once qualified, you will receive our UltraKit, which includes sales and marketing materials as well as technical information to get you up and running as an UltraBac Solution Provider! For additional information, please contact sales@ultrabac.com.

Field names shown in red are required.

Company Name
First Name Last Name
Title
Address 1
Address 2
City State
Country Postal Code
Telephone FAX
Email Company URL
Annual Revenue
# of Employees
at Your Location
# of Locations Geographic Coverage

Local
Regional
National
International

What sales/service efforts generate your major customer revenue?
Consulting
Software Sales
Hardware Sales
Technical Support
Training
Software Development
Networks
Web Design
 
Operating Systems

Windows 95/98/2000
Windows NT
UNIX
Other

 
What types of marketing vehicles does your company use to promote products to your customers?
Seminars
Ads
Direct Mail
Web Site
Trade Shows
Other   
How did you hear about the UltraBac Solution Provider Program?
Trade Show
Ad
Press
Mailing
Word of Mouth
Other   
Our success depends on your success and your input is important to us. What would you like to see included in our Solution Provider Program to make it more meaningful to you?