Enter your details below to apply for a dealer account. If you have any questions relating to this application please call us on +44 (0)20 8319 7777
    
    Company Details
    
	You must enter your company name.Company Name needs to be a word, or text
    
	You must enter the date your company first started trading.Trading Since needs to be a word, or text
    
	Parent Company needs to be a word, or text
    
	You must enter your Company Registration Number.Company Reg. No. needs to be a word, or text
    
	You must enter your registered VAT/Tax Number.VAT/Tax Number needs to be a word, or text
    
	You must enter your registered Economic Operators Registration and Identification Number.EORI Number needs to be a word, or text
    
    
	Please tell us how many internal sales people you have.Internal Salespeople needs to be a word, or text
    
	Please tell us how many external sales people you have.External Salespeople needs to be a word, or text
    
	Website URL needs to be a word, or text
    
	Fax needs to be a word, or text
    
	Please tell us your name (the name of the person filling in this application.)Your Name needs to be a word, or text
    
	Please tell us your email address (the email address of the person filling in this application.)Please check your email addressYour Email needs to be a word, or text
    
	Additional Info. needs to be a word, or text
	
 
    
    Contact Details / Mailing List
    
    
    
    Head Office Address
    
	You must enter your address.Address needs to be a word, or text
    
	Address Line 2 needs to be a word, or text
    
	Address Line 3 needs to be a word, or text
    
	You must enter your town or city.City needs to be a word, or text
    
	County needs to be a word, or text
    
	You must enter your country.Country needs to be a word, or text
    
	You must enter your postcode.Postcode needs to be a word, or text
    
    Please advise your appointed account manager of any additional mailing addresses.
    
    Standard Delivery Address (if different to above)
    
	Address Line 1 needs to be a word, or text
    
	Address Line 2 needs to be a word, or text
    
	Address Line 3 needs to be a word, or text
    
	Town / City needs to be a word, or text
    
	County needs to be a word, or text
    
	Country needs to be a word, or text
    
	Postcode needs to be a word, or text
    
    Agreement
    
        
        
	
   
    
	You must tell us the name of the company's owner or director.Directors Name needs to be a word, or text
    
	You must provide an email address for the company's owner or director.Please check the Directors EmailDirectors Email needs to be a word, or text
    
	Please provide the official job title / position of the company's owner or director.Position needs to be a word, or text
    
    
        
         A notification message will be sent to the above named director, therefore please ensure that the email address provided above is a company domain email address, otherwise your application may be delayed.
    
    
        
         We would like to contact you about our products and services by email, phone, or post. For information on how we collect and use your personal data, visit our 
privacy policy.
        
        
        
        I agree to receive marketing communications from Clevertouch by Boxlight.
    
 
    Terms and Conditions
    
        
    
    
        Please be aware that we have a "payment for first order" policy, then 30 days credit is offered based around payment history and subject to approval.