 |
||||||||||||||||||||
|
CUSTOMER SERVICE
Complete
Solutions
for the
Internet
 |
 |
Welcome to PrimeGEN reseller Program. Use this form to apply for your reseller account with us and start enjoying discounted prices and special benefits, right today.
Reseller Program Application
| Company | |
| Contact Name | |
| Contact Email | |
| Contact Phone | |
| Fax # (optional) | |
| Mailing Address | |
| City, State | |
| Country, ZIP |
Main Account Information
| Main Domain | www. |
| Select One | This domain is being
hosted by PrimeGEN This is a new domain, & will be hosted by PrimeGEN I want to transfer this domain to PrimeGEN |
Note: Your main account and contact Email address will be used for account verification and billing purposes |
|
Account Type
Please mention here, the preferred method to start :
CONDITION ( 1 )
|
CONDITION ( 2 )
|
CONDITION ( 3 )
|
CONDITION (1) : I already have the following 3 domains with PrimeGEN. My next account will be available @ discounted price and no setup fee.
Existing Domain #1
Existing Domain #2
Existing Domain #3
CONDITION (2) : I want to start enjoying all the reseller benefits today, starting with my first set of domains as follows :
New Domain #1
New Domain #2
New Domain #3
NOTE: Please use the Reseller Services Form to setup all new domains on our server.
CONDITION (3) : I wish to start with RSX or NTX package.
Payment Information
All new members of the reseller program need to provide a valid credit card ( Amex, VISA, MasterCard ) for records. You can then choose the preferred method of payment for your account.
| Credit Card Type | |
| Credit Card # | |
| Expiration Date | ( month/year ) |
| Name on Card | |
Preferred Billing Method |
Use this card for all billing my account Company Check / Money Order in mail |