Reseller Application

To apply to be a reseller of Amulet Devices products, please complete the form below. Fields marked * are required.

Primary Contact

First Name

Last Name

Title

E-mail

Main Phone Ex: +1 (408) 331-3300

Cell Phone

Fax

Company Information

Company Name

Website Ex: http://www.example.com/

Address

City/Town

State / Province

Zipcode / Postcode

Country

Phone Ex: +1 (800) 425-9385

Fax

About Your Business

Year Established Ex: 1998

Business Form

Last Year's Revenues

Main market segment

How many Microsoft Windows Media Center systems do you sell or install annually?

Market Territory

Main products currently carried and since when

Ex: Control4 (2006), Lifeware (2008), Crestron (2004)

About Your Staff

Principal / CEO

Total Number of Employees

Number of Sales Personnel

Number of Technical Personnel

Additional Comments

Comments

How did you hear about us?