Reseller Information


Please fill in the requested information below.
We will review your application usually within one working day.
After review you will be sent notification when the account is active.

Thanks - Durkin Computing Sales Team


Your Name and Company
as it appears on your credit card 		Your Billing Address
as it appears on your credit card
First Name:
Last Name:
Company:
Address:
City:
State:
Postal Code:
Country:
Email and Phone Number
Email of the recipientfor download notifications. 		Profile Password
This password is used to access information filled out in this form.
Email: Account Password: 
Phone:  
  NFRs requested for employees - Remember to include workstations and laptops!
  NFRs requested for classroom computers - Include the total # of classroom workstations
Notes


 

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