Reseller Application Form

If you are a company and would like to be qualified as a reseller/distributor and/or receive quantity pricing for your business needs, please fill out this online application. You can skip the EIN and State Resale Number if you are located outside of the United States.  One of our account managers will contact you as soon as we have reviewed all the required information and received any required documentation.

*This application must be completed in full.  Incomplete applications will be rejected.  Completion of this application does not imply that you have been accepted as a Lochtech Authorized Reseller/Distributor.
Please complete all fields
Business/Organisation
Federal Tax ID (EIN)
State Resale Number
Contact First Name
Contact Last Name
Title
Address
City
State
Zipcode
Country
Contact Telephone
Contact Fax
Contact Email
Company URL?
Year established?
Number of sales locations?
Number of employees?
Expected annual revenue from our products?
From which market segment does the majority
of your revenue come? 		Education
End User Sales
Government
Small/Medium Companies
Large Companies
What is the nature of your business?
Please list a sampling of products you currently sell.
What do you specialize in?
Please Specify which products interest you
What materials would you like to recieve?
How did you hear about our reseller program?  
Please enter any comments in the space provided.  

Do you have a question or need technical assistance with one of our products or services? You may attain support for any Lochtech product or service via our support lines and ticketing system. Please contact us.

  • Phone: (800) 509-8401 option 5
  • Email: support@lochtech.biz


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