Reseller Application All fields must be filled in for complete processing if information is not available put "N/A" NOTE: If the there is RED "R" in front of the field then that field is REQUIRED If you want to send us a simple note, please fill our "Contact Us" form. Company Name : R Your Name: R Mail to Address: R City: R State: R Zip Code: R Country: R    Ship to Address: R if same, Please put SAME City: State: Zip Code: Country: Telephone Number: R with country and city code Fax Number: R with country and city code Contact Person/s with Title and Position: Total Number of Total Employees: Number of Salespeople:   Number of Servicemen:   Number of Install People: Shop Rate per Hour $   Field Rate per Hour $    Area or Territory Covered: R What are your Company's annual sales: What kind of test-service equipment do you use: What type of clients does your company have: What have you sold them over the past 2 years: What frequencies have been allocated in your country for rural telephony: Please Mark all areas of interest (check all that apply) Point-to-Point Wireless Telecommunications PTEL  1-Line Phonelink® RMOD Radio modems (data only) 19.2/64 Kbps DTEL 3-Line Phonelink® (2+1, voice and data) - 19.2/64 kbps QTEL 4-Line Phonelink® - 64 Kbps MTEL 8-Line Phonelink® - 64 Kbps ETEL 30/60 Line Phonelink® (E1 Microwave) Point-to-Multipoint Wireless Telecommunications System35 - Wireless PABX RET - Roadside Emergency Telephone / Call Box Systems E1RT TDMA, E1 Rural Telephone - 2mb DRRT TDMA-TDD, E1 Rural Telephone Other Equipment Available From Telemobile Two-way radio systems (handhelds, mobiles, base, repeaters and telemetry)   Have you sold Telemobile products in the past: Yes (Date)   No  Have you serviced Yes (Date)   No Please tell us the product lines now selling and/or servicing : Will your company purchase and maintain a demonstration system for in-store use: Yes   No Will your company send your technicians and sales personnel to be trained at our factory: Yes   No Please tell us any other information about your company history & market you think may be useful including your website: Email address: R Also if you are already working with someone at Telemobile please let us know so we can speed up your request. Page Last Updated February 3, 2004
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