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Primary Contact Details

1. Firstname(required)
2. Lastname(required)
3. Telephone(required)
4. Fax
5. Email(valid email required)
6. Where did you hear about our Reseller program(required)

Trading/Company Details

1. Trading Name(required)
2. Type of Business Individual Sole Trader Partnership Private Company Public Company Other (required)
3. Legal Entity Name(required)
4. ABN

Address

1. Address Line1(required)
2. Address Line2
3. Suburb or Town(required)
4. State(required)
5. Postcode(required)
6. Country(required)
7. Website

Questionnaire

1. Do you have a physical retail presence?
2. Yes No
3. Business Category
4. Retail (Home or Office)
   Retail (Shop Front)
   Systems Integrator
   Consultant
   Other
   
5. Please describe your business
6. Please explain why you want to be a Carbonite reseller.
7. How long has your business been operating? 1 year 2 - 5 years 5 - 10 years 10+ years
8. Employees 1 - 9 10 - 20 20-50 50+
9. Target Markets?
10. Corporate
    Small Business
    Home Users
    Industry Specific
    Other
    

 

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