Below is the application for becoming a BayTech products dealer/reseller. Please fill out all the information as accurately and completely as possible. This application is designed to be filled out on the web and submitted directly from this page, as opposed to printing it out and faxing it in. Use the TAB key and the SHIFT+TAB keys to move between fields, hitting ENTER will submit the form in most browsers.

Thank you.

 

Application Information  
Company Information
BayTech Contact Person
(who we should contact in your company)
E-mail Address
Contact Person
(who you need to contact in our company)
Website
Co. Name
Name of Owner/CEO/Principal
Sales Manager
Sales Manager's Ph. #
Purchasing Manager
Purchasing Manager Ph. #
Service Manager
Service Manager Ph.#
Resale Tax No
Billing Address
Street Address
Town or City
State
Zip
Phone
Fax
Mailing Address
Street Address
Town or City
State
Zip
Phone
Fax
Shipping Address
Street address
Town or City
State
Zip
Phone
Fax
Primary Market Focus:
(check all that apply)
Home users/walk-in customers
Major Corporations (Fortune 1000)
Small Business
Medium Business
Government
Federal
State
Local
Educational
Banking and Insurance
Medical/Health Care
Telecommunications
Other
Product Information
Which BayTech products do you plan to purchase?
RPC-Remote Power Control Switch:
RPC with network access
RPC with modem
DS-RPC-Data Switch/ Power Control
DS-RPC with network access
DS-RPC with modem
DS-Series Data Switch
M-Series DAC
Serial communications
Network communications
Other Products
Statistical Multiplexers
Multiport Controllers
Printer Sharing
Standing Order
Would you be interested in a standing order? Check if Yes:
Other Information

Which best describes your type of   business?
VAR       Retail       Consultant      Other
Number of sales people:

(outside) (inside)
Number of sales support personnel
Number of service technicians
Estimated annual sales
Major product lines you sell:
Where did you learn about BayTech?
Magazine
Mailer
Salesperson's Recommendation
Store Display/Demo
Other
Submit Information
Untitled Document