Customer Information


   Tax Information

   Contact Information
Main Sales Contact *

Main Service Contact

Main Accounting Contact *

   Additional Information
Vertical Market Information

Business Market Information

Geographies Served

Upload Reseller Certificate

Drag & Drop Reseller Certificate Here
   Financial Information
Primary Contact

Additional Information

Upload Financials

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Drag & Drop Trades / Bank Information Here
   Application Authorization and Submission

* By agreeing to this reseller application form, you are confirming that you have approval authorization at your company and will be bound by the Lifeboat Distribution’s Reseller Terms & Conditions, which are available at: Lifeboat Distribution Terms & Conditions.
Lifeboat Distribution
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