Resellers

Reseller Application Form

Thank you for your interest in Nology and our products.

Nology is a channel focused company and we try our best to protect our reseller channel by ensuring that we only transact with ICT resellers, installers and service providers.

You will be required to attach a copy of your company registration document in this application under the "Documents Required" section.

If neither your company's website nor your company registration documents can prove your company's compliance to the criteria as listed above, please submit your Company Profile as proof. We will not be able to process your application if we cannot confirm compliance to these criteria.

We will process your application as quickly as possible, however please note that it may take up to two business days or longer if we cannot confirm compliance to the required criteria from the information and documents provided.

Once your application has been approved, we will send you a confirmation email and provide you with your account number and our latest pricelist.

Please note that this is not an application for credit facilities, but to confirm your company information and register you as a reseller on our system.

Please complete the application form below.
Fields marked with * are mandatory.



Company Information

Registered name of business:*
Trading name of business:*
Type of business:*
Company registration no.:*
VAT registration no.:

Business Address & Contact Details

Please complete the Head office details below (*Required).

If you would like to add branches, please use the check buttons to select more branches and complete these fields.

Branches:*

Head Office Details:

Physical address: (Head office)*
Province: (Head office physical)*
Area code: (Head office physical)*
Country: (Head office physical)*
Postal address: (Head office)*
Province: (Head office postal)*
Area code: (Head office postal)*
Country: (Head office postal)*
Telephone no: (Head office)*
Fax no: (Head office)*
Primary email address: (Head office)*
Re-type email address: (Head office)*

Branch 1 Details:

Physical address: (Branch 1)
Province: (Branch 1 physical)
Area code: (Branch 1 physical)
Country: (Branch 1 physical)
Postal address (Branch 1):
Province: (Branch 1 postal)
Area code: (Branch 1 postal)
Country: (Branch 1 postal)
Telephone no: (Branch 1)*
Fax no: (Branch 1)*
Email address: (Branch 1)
Contact person: (Branch 1)

Branch 2 Details:

Physical address: (Branch 2)
Province: (Branch 2 physical)
Area code: (Branch 2 physical)
Country: (Branch 2 physical)
Postal address (Branch 2):
Province: (Branch 2 postal)
Area code: (Branch 2 postal)
Country: (Branch 2 postal)
Telephone no: (Branch 2)*
Fax no: (Branch 2)*
Email address: (Branch 2)
Contact person: (Branch 2)

Branch 3 Details:

Physical address: (Branch 3)
Province: (Branch 3 physical)
Area code: (Branch 3 physical)
Country: (Branch 3 physical)
Postal address (Branch 3):
Province: (Branch 3 postal)
Area code: (Branch 3 postal)
Country: (Branch 3 postal)
Telephone no: (Branch 3)*
Fax no: (Branch 3)*
Email address: (Branch 3)
Contact person: (Branch 3)
Website url:*
Nature of business:*
Core market focus:*
Number of employees:*
Business established date:*
Where did you hear about us?:*
Where did you hear about us (Other):*
Sales person spoken to:*
Which products/brands are you most interested in:*
Would you like to register as a 3CX Partner?:
Preferred trading currency (if non-resident company):
Which other trade suppliers are you registered with?*


Directors / Partners / Members / Owner Details

Full name: (1)*
ID no: (1)*
Designation: (1)*
Address: (1)*
Full name: (2)
ID no: (2)
Designation: (2)
Address: (2)
Nology is committed to Black Economic Empowerment and as part of this commitment Nology contributes annually to the Economic Development of selected Black Owned Businesses. For potential consideration of such contribution please indicate if you have:

Accounts / Buyer / Technical Details

Accounts contact person:*
Buyer contact person:*
Technical contact person:*
Email address for quotes & invoices:*

Contacts to receive the monthly pricelist and specials:

Additional name: (1)
Additional name: (2)
Additional name: (3)
Additional name: (4)


Accounts email:*
Buyer email:*
Technical email:*


Additional email: (1)
Additional email: (2)
Additional email: (3)
Additional email: (4)


Documents Required

Applicable to Close Corporations, Companies and Trusts:
Entity's Registration documents

Applicable to Individual / Sole Proprietors:
Copy of ID document of applicant

Cipro / CIPC certificate:*
Additional documents:


Agreement

By submitting this form I hereby confirm that:

The information contained in this form is true and correct.
I am duly authorised to enter into agreements for/on behalf of the applicant.
I have read and understood the distribution terms and conditions of Nology and accept them as binding upon the applicant.
I understand that this is a dealer registration only and not a credit application.

I:*
agree to the Terms & Conditions and above agreement:*
Verification:

About Nology

Founded in 2001, Nology combines trusted business fundamentals, technical expertise and over 15 years' experience to provide quality Broadband, Wireless, Networking and VoIP solutions to leading service providers, network operators and systems integrators across Southern Africa.

Nology represents, distributes and supports some of the leading international brands and we are continually expanding our product offering. We have a strong reputation and proven track record in our industry and are trusted by some of the largest ISPs and network operators in South Africa.

Gauteng Office

Icon Mail sales@nology.co.za

Icon Phone 010 980 0000

Icon Home Unit 4 Louwlardia Business Park
122 Bavaria Road, Centurion
Gauteng, 0157, South Africa

Cape Town Office

Icon Mail cptsales@nology.co.za

Icon Phone 010 980 0002

Icon Home Unit C52 Platinum Junction
School Street. Milnerton
Cape Town, South Africa