Become a 5Gstore Reseller

To become a 5Gstore Reseller, please complete the below form. This application will help us understand your business and what solutions you are providing. Please provide us as much information as possible, and we will contact you soon with more details.

* fields marked with an asterisk are required

Contact Details First Name: * Last Name: * Title: Phone Number: * Email Address: * Password: *

Company Information Company: * Address: * City: * State: Type a choice below ... * Zip Code: * Country: United States Phone Number: * Website: Preferred Payment Method: Credit CardCheckWire TransferNet 30 Annual Commitment: $0 - $10KOver $10KOver $200KOver $750K

Additional Information Number of Employees: * Number of Sales Reps: * Number of Support Reps: * Average annual revenue in last 3 years: Which Products and Monthly Volume of each: *

Business Information Business Model: Management Service Provider Value Added Reseller Retailer Online Retailer Distributor Other (please specify) Vertical Market Focus: Government Broadcasting Residential Industrial Public Safety Service Provider Hospitality Transportation Business Continuity Other (please specify)

Current Product Offerings Product Offerings: Company Experience:

Interests SimplyFailover Reseller Peplink Reseller SureCall Reseller Cel-Fi Reseller NetComm Reseller Sierra Wireless CradlePoint Wilson White Label eCommerce White Label Failover Fulfillment Activation Services

Resale Certificates California Sales Tax Certificate: Expiration Date: Colorado Sales Tax Certificate: Expiration Date: Illinois Sales Tax Certificate: Expiration Date: Kansas Sales Tax Certificate: Expiration Date:

Comments Comments/Questions: How did you find us: