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AVG (AU/NZ) Reseller Application Form

Thank you for choosing to join the no-commitment AVG Australia/New Zealand Reseller Program for AVG Security Products.

To get started, please fill in this form and we'll get things moving along. Before you know it, you'll be adding value to your customers by providing them with some really innovative and powerful AVG security software products.

All required fields are indicated with a red * asterisk.

Referral Information

Please let us know how you were referred here.

 How did you hear about our Reseller Program?*

Primary Contact Details

Please provide contact details for the person who you want to receive all regular communication from us.

 Title*
 First Name*
 Last Name*
 Telephone Contact*  (please include area code)
 Facsimile  (optional)
 Mobile / Cell Phone  (optional)
 E-mail Address*
  (confirm your e-mail address below, by typing it again)

Owner/Managing Director Details

Please provide the details for the Owner/Managing Director

 
 Title*
 First Name*
 Last Name*

Trading/Company Details

As a Reseller, you must be a legitimate trading entity conducting business.

 Trading Name*  
 Type of Business*  
 

What is a Legal Entity Name? If you're a Sole Trader or Partnership, your legal name may be different than your trading name. For example, Joe's Software might really be Mr. Joseph Smith trading under a business name.
 Legal Entity Name*  
 Company ABN (?)  (required for Australian businesses)

Address

This is the address where we will send invoices and other materials from time to time.

If you prefer to receive mail to a PO Box please let us know by email once you have submitted your application. PO Boxes will not be accepted at this stage.

 Address Line1*
 Address Line2  (optional)
 Suburb or Town*
 State or Province*
 Postcode or ZIP*
 Country*

Questionnaire

To assist us in understanding your needs as a reseller, please answer the following questions.

 Do you have a physical retail presence?*  
 Which category best describes the business?*
(choose all that apply)




 Please describe your business*
 Please explain why you want to be a reseller for AVG AU/NZ?*
 What is your website address? (optional)
 How long has the business been operating?*  year(s).  
 How many employees working in the business?*  employee(s).  
 Which markets do you primarily target?*
(choose all that apply)





Have you made any mistakes? Please review these details before proceeding.

What happens next?

After pressing the "Continue to Next Step" button our system will immediately use the information provided to create a new reseller file on our system. On the pages coming up you'll be asked some more questions about your application.