webstats

avast! Reseller Application Form

General contact

Note: Your contact details will be used to prepare your reseller contract. Some registration details will be displayed as your contact information on our website.
* Company name:
Displayed name or Trading name:
* Represented by:
* Job position:
* Street address:
* City:
* Zip Code:
* Country:
* State/Province:
* Telephone number:
Fax number:
VAT number:
If you are from an EU country, please provide your current VAT number in the international format [example for the Czech Republic is CZ123456789].
Alternative business address

Contacts

* General contact email:
* Contact for invoice purposes:
* License delivery email:
* Customer support email:
* Company website:
Please provide us only with email addresses that are associated with your company's website domain [e.g. name@company.com]. Your customer support email will be listed in the partner section of our website.

Company details

* Number of employees:
* Who is your typical customer?: