Reseller Registration Form

Date:__/ __/____
To: Shah Net Technologies Pvt Ltd
28, Embassy Market B/h Sales India, Off Ashram Road,
Ahmedabad-380 009, Phone: 6584786

   We are interested in becoming value added reseller of www.shahnetdomains.com. We are glad to submit the information in the following Reseller Registration Form:

Name of the person /company ______________________________________
who wants to become reseller (Resellers Certificate will be issued in this name)
Detail Address: __________________________________________________
  __________________________________________________
Contact person:___________________________________________________
Date of Birth /Date of Incorporation:__________________________________
Phone No:________________________________________________________
Fax No:__________________________________________________________
Email Address: ____________________________________________________
Postal Address for Sending } ___________________________________
Commission Cheques: } ___________________________________
A Brief Bio-Data } ___________________________________
/Company Profile: } ___________________________________
Nature of Present Activity:__________________________________________

How much web hosting business you estimate you can get

Value (Amount in Rs per month):_____________________________________
                      Or
Number of Customers per month:_____________________________________

 

_________________
Signature of Reseller