Reseller Application Form



Dear Valued Customer,
If you would like to become an Amatec reseller, please complete the form below and we'll get back to you as soon as we can!
Company Name*
Please type your full name.

Trading Name
Please type your full name.

Registration No.
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VAT Registration No.
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Contact Person*
Please type your full name.

Email Address*
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Telephone No.
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Fax No.
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Physical Address
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Postal Address
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Date Established
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Previous Trading Name(s)
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Years Under Current Management
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Years At Current Address
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Type Of Business
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Supporting Documents
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