Account Setup Application Form
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2100-13551 Verdun Place, Richmond, BC, Canada, V6V 1W5
Tel: 1-604-273-3003 Fax: 1-604-273-3023
Website:
ACCOUNT SETUP APPLICATION FORM
Step #1: Please fill and sign this Account Setup Form and Credit Application Authorization Form,
Step #2: Please fax to 1-604-273-3023 or email PDF format to
Step #3: Please MAIL original signed form to ZCOVER INC. 100-13551 Verdun Place, Richmond, British Columbia,
Canada, V6V 1W5 Attn. Account Setup
CONTACT INFORMATION
Business Name _________________________________________________________________________________
Business Address _______________________________________________________________________________
City/State _____________________________Zip/Postal Code _________________Country__________________
President / Owner __________________________________ Phone # (____________)________________________
Federal Tax ID# _____________________ Web Site ____________________________ Years in Business _______
Major Business and Services ________________________________________________ No. of Employees ______
Purchase Contact: ________________________________ E-mail_________________________________________
Phone # (________) _______________________________ Fax # (____________)____________________________
A/P Contact______________________________________ E-mail _______________________________________
Phone # (________) _______________________________ Fax # (____________)____________________________
BUSINESS INFORMATION
We are: □ On-line Store
□ Retail Store
□ Service Provider
□ Wholesale Reseller
□ Distributor
□ Hospitals
□ Education
□ Government
□ Business Internal Use
□
others_________________
We are interested in products and services related to:
□ Cisco
□ Polycom
□ Blackberry
□ iPod, iPhone & Mac
□ Other Smart/IP phones ______________
□ Carrying Cases
□ Bluetooth
□ Batteries
□ Dock Chargers
□AC & Auto Power Adapters
□ Keyboard & Covers
□ Mouse & Covers
□ Other Input Devices_________________________________
□ Customized Case / Cover Design
□ Corp Logo Printing
□ Others________________________________
We are Authorized distributor of ____________________ (product Brand) in _______________________area.
We are member of __________________________________________________Program/ Board /Organization
We are Business Partner of ____________________________________________________________________
We are Authorized Service Center of ____________________________________________________________
1-2 pages
zCover Account Setup Application Form Version 9.1
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Parent category: Business