Reseller Application

Please complete the form below to make an inquiry about becoming a Reseller (in the United States or regions outside of the United States, Canada and Australia).

*All form fields are required

Company Name: Website: Contact Name: Email Address: Telephone Number (international): Address: City: State: Zip / Postal Code: Country: How many years have you been in business?: What is your reseller territory? Type of micrographic equipment installed in reseller territory? Canon Minolta Kodak E-ImageData Describe your micrographics sales and support capabilities Please enter the answer to the following sum: 15 minus 14?

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