Reseller Onboarding Form

To register, please take the time to fill out the information below.

Choose your representative

1. Company Name

2. Company Registration Number

4. Company Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Country

5. Primary Contact Person

Primary Contact Number

Primary Email

Secondary Contact Person

Secondary Contact Number

Secondary Email Address

Your Company Website

Backspace Technologies (Pty) Ltd

TEL: +27 10 023 0320

Physical Address:

17 New Church Street

Cape Town

8000