Request edit access
RESELLER APPLICATION FORM
Thank for your interest in being a ACW Distribution Phils., Inc. Reseller. This application form begins the process of becoming one of our channel partner. Our Management team will review your application and get back to you in a few days with next steps.
Sign in to Google to save your progress. Learn more
CUSTOMER INFORMATION
Fill out the online application form below. (Make sure you fill out all pertinent details!)
*
Business Name: *
Trade Name: *
Business Registration: *
TIN (Tax Identification Number): *
Established Date: *
Number of Employees: *
Nature of Business: *
CONTACT DETAILS
Business Address: *
Zip Code (Business Address): *
Delivery Address: *
Zip Code (Delivery Address): *
Office Telephone: *
Office Fax: *
Company Email: *
Company Website: *
AUTHORIZED PERSONNEL
Owner's First Name: *
Owner's Last Name: *
Email Address: *
Contact Number: *
PRIMARY AUTHORIZED SIGNATORY
First Name: *
Last Name: *
Designation: *
Email Address: *
SECONDARY AUTHORIZED SIGNATORY
First Name: *
Last Name: *
Designation: *
Email Address: *
Supplier Reference
Company Name: *
Address: *
Contact Person: *
Designation: *
Contact Number: *
Email Address: *
Bank Reference
Bank Name: *
Address: *
Contact Person: *
Designation: *
Contact Number: *
Email Address: *
PRODUCT INTEREST
Information Security
Network Connectivity
Data Management
PREFERRED CREDIT TERM
Credit Term *
Please submit the following documents to info@acw-group.com.ph.
Thank you for taking the time to complete this form. Your application goes through careful review by our Sales Team. We will be in touch with you soon. We appreciate your request to be an authorized reseller of our products and services. Thank you for considering us for a partnership.
Privacy Policy
All information received will always remain confidential. Maintaining and protecting the privacy of personal data you share with us is important to us. ACW Distribution (Phils.), Inc. is committed to implementing appropriate security measures to maintain the confidentiality, integrity, and availability of your personal data, in accordance with the Data Privacy Act of 2012 (“DPA”).
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy