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Qreseller Membership Registration
Thank you for your interest in the BenQ Qreseller Program. Please read all the program rules before completing the application. Once you have submitted this application you will be activated to get you started as BenQ's reseller member and enjoying all the benefits.

Please note: each field marked by an asterisk ( * ) must be completed in order for us to process your application.
* Required field  
   
   
 

Company Info
 
* Company Name:
* Year Established:
  Number of Employees:
* Primary Business:
  URL:
      Example: www.BenQ.ca
   
   
   
 

Primary Location
 
* Address:
* City:
* Country:
* Province:
* Postal Code:
* What is the function of this location:
   
   
   
 

Primary Contact
 
* First Name:
* Last Name:
  Title:
  Month of Birth:
   
  Phone
* Phone: -
  Phone Ext.:
  Fax: -
   
* E-mail:
* E-mail - Verify:
* Password:
* Password - Verify:
   
   
   
  Distributor
* Distributor:
* Account:
Distributor Sales Rep. First Name:
Distributor Sales Rep. Last Name:
Tel:
Email:
  Are you a member of:
   
   

Mailing List
 
 
Yes No
From time to time BenQ may send you E-mail regarding BenQ products, services and special offers. If you do not want to receive such messages, please select "NO" from the buttons above.
   
   
   
 
* I agree to the Qreseller Program Rules & Usage Guidelines
  By clicking the submit button below you agree to the above terms and conditions of the BenQ Qreseller Program, General Rules of the BenQ Qreseller Program, Lead Referral Program Rules and Demonstration Unit Program Rules:
 
 
 

 

 

 


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