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

3. Vat Number

4. Company Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Country

5. Billing Contact Name and Surname

6. Billing Contact Numbers

7. Billing Email Address

8. Technical Contact Person Name and Surname

9. Technical Contact Numbers

10. Technical Email Address

11. Alternative Contact Person Name and Surname

12. Alternative Contact Numbers

13. Alternative Contact Email Address

Backspace Technologies (Pty) Ltd

TEL: +27 10 023 0320

Physical Address:

17 New Church Street

Cape Town

8000