Amphora International, Inc.

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Contact Information

Company Name *

First Name *

Last Name *

Region *

Country *

Address *

City *

State *

Zip Code *

Title *

Email *

Phone *

Extension

FAX

Website

Company Information

HEREBY CERTIFY that I hold a valid seller's permit No. * issued pursuant to the Sales and Use Tax law; that I am engaged in the business of selling *

Year Established *

Number of Employees *

Annual Sales Revenue *

Monthly Notebook/white book/laptop Volume *

Whose brands of chrome books, tablets and note books do you resell? (Mark all that apply)

Apple

Compaq

Dell

IBM/Lenovo

Panasonic

Sony

Toshiba

White book

Others, please list

Business Type

Others, please list

Vertical Market Specialty

Others, please list

Define you primary business. If more than one type applies, mark all that apply from 1-5, with 1 being the most business and 5 being the least business.

SMB

Fortune 1000

Government (Federal, State or Local), and Education

Store Front (Sell to Consumer, SOHO and SMB)

Others, please list:

Do you currently resell MAXCases products? *

What other brands of mobile accessories do you resell?

Industry

Which sales portal would you like access to? *

Choose Distributor(s)
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Amphora International, Inc.

Shop

About Us

Our Company

Where to Buy

Grocery Stores & Supermarkets
Distributors