CES Dealer Application Form

Dealer, Reseller or Software Partner Application Form...

Please complete the following form to apply to become a CES Wireless Dealer or Partner. Once authorized, dealer and partners can resell CES Wireless products, and have access to additional product resources online.

All required fields must be completed in order for the application to be processed. An Internet e-mail address is required. Use the Tab key to move from field to field or scroll down when needed.

A representative will contact you via e-mail as soon as your application is received, processed, and your username and password, if requested, become available.

Please fill in the form and press the "Send" button at the bottom.

DO NOT COMPLETE THIS FORM FOR PRODUCT SUPPORT. FOR SUPPORT REQUESTS, CLICK HERE: SUPPORT

Tell us how to get in touch with you: (*required)

First Name:*		Last Name:*
Title:		Company:*
Tel:*		Fax:
E-mail:*
	Mailing Address			Shipping Address
Address 1:*			Address 1:
Address 2:			Address 2:
City: *			City:
State: *			State:
Postal Code:			Postal Code:
Country: *			Country:

Are you an existing CES Wireless Dealer/Partner:
Yes No

Are you currently working with someone at CES Wireless:
Yes No If yes who:

* What is your Web Site Address:

Describe your company and major business areas in the space provided below: