Please fill in the informations required in this form and click the submit button at bottom of page, we will send you an email and register you as our resellers once we approved your application.
(NB: You need to have a Value Co account registered, applications with email account not registered will be automatically rejected.)
What is your Email Address used for Value Co Online Store?
I agree to receive the promotions and specials by email
What is your full name?
Cell Phone Number
What kinds of products are you resell in?
Where are you planning to resell the products?
Other ( Please Specify on next answer)
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service