Now you can become one of us - a Microform Authorized Reseller! Please use the form below to tell us about yourself, your company and your plans for selling Microform scanners. We will review your application and respond as quickly as possible.
Company Information
Company Name:
Your Name:
Your Title:
Phone Number:
Email Address:
Mailing Address:
Address:
City:
State: Zip Code:
Business Information:
Business Type:
Primary Line of Business:
Products Currently Sold:
Services Offered:
Which of the following hardware products are you authorized to sell?
Kodak Bell & Howell Canon Fujitsu Scan Optics Other
Number of Employees:
Annual Revenue in Dollars:
Percentage of Sales in Hardware:
Percentage of Sales in Software:
Percentage of Sales in Services:
Please tell us briefly how you plan to promote and sell our products:
Contact Us
Reseller Info
Microform America, LLC
1633 Sands Place, Ste. B
Marietta, GA 30067
Phone: (770) 984-2171
Fax: (770) 953-8399
email: info@microform.us
© 2011 by KAB Management
Last updated 08.31.2011