Simplewan Reseller Application Phone Owner / Authorized Full Name * Contact Email Address * Company Name * Best Phone Number * Sales Point of Contact for the account * Accounts Payable Point of Contact for the account * Best Billing & Shipping Addresses Address Line 1 * Address Line 2 City * State * - Select Province/State - Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming ZipCode * Best email address for partner portal access (only one log in per account, you may want to use a distribution email) * Copy of Sales Tax / Resale Exemption Certificate Add File
