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Are you interested to become our reseller?
It is easy! Just fill in the form as below and we shall reply you once receive your application.

Company Type :
Limited Co.
Sole Proprietor/Partnership
Company Name :
Registration No :
Date of Incorporation :
Website :
Address :
Contact Person :
Email :
Tel No :
Fax No :
Nature of Business : Retailer Distribution System Integrator Cyber Cafe
Other (Please specify)
Annual Turnover : < RM 1 Million 1 - 5 Million 5 - 10 Million > 10 Million
No. of Employees : < 10 Persons 10-20 Persons 20-50 Persons > 50 Persons
Please brief us your company current major suppliers & products:
  Supplier Name Product Supplies
1.
2.
3.
Please list down product, model & quantity that you are interested to purchase from us:
  Product Model No. Quantity Intend to purchase
1.
2.
3.
4.
5.
How are you going to promote our products if we appoint you as our reseller? :
From where do you get to know Vertex ? :
Name :
Designation
Date