Reseller Application Form v2
Reseller Application Form v2
Fax No Facebook
Total No of Staffs
II. CONTACT DETAILS Kindly provide three different name and contact details. CEO / Managing Director Name Designation Tel No (O) Tel No (M) Email Technical Administration
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III. BANK ACCOUNT DETAILS Bank Name 1 Account No Bank Name 2 Account No
IV. ADDITIONAL INFORMATION Are your current company / business registering any .my domain name (for existing MYNIC Authorised Reseller)? Yes. Please state the total no per year : No Are your current company / business registering any domain name other than .my? Yes. Please state the extension and total no per year : No Who will be your targeted customer? Individual Government/Statutory Body Education Centre/School/University SME Society/NGO Others. Please state :
Are your current company / business having any experience in IT related business? Yes. Please elaborate : No Are your current company / business able to support and participate in MYNIC events as and when needed? Yes No Are your current company / business able to provide payment facilities to the customers if you are chosen as MYNIC Reseller? Yes No Please tell us in less than 300 words why you want to be MYNIC Reseller;
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By completing and signing this Reseller Application Form, we hereby certify that: 1. All the information supplied in this application is true and correct. 2. We understand that additional documents and information may be required before consideration can be given to this application. 3. We understand that MYNIC may decline this application without giving any reason. Name of Applicant : Authorized Signature Name /Designation : Company Stamp Date : : :
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