Reseller Application Form

Thank you for your interest in Headset Solutions and our products.

We are a channel-led company and require that our resellers comply with our strict requirements which are put in place to protect our channel.

Please attach a copy of your company registration document as required below. We will process your application as quickly as possible, but it may take longer if we need to confirm compliance to the required criteria.

Once we have approved your application, you will receive a confirmation email with your account number and our pricelist. Please note that this is not a credit facility application but to confirm your company information and register you as a reseller.

Please complete the form below and attach the required documents.

Company Information

Head Office Address & Contact Details

Website url (please leave field blank if you do not have a website):
YYYY dash MM dash DD
Which brands are you most interested in:

Directors / Partners / Members / Owner Details

Full name and surname: (1)(Required)
Full name and surname: (2)

Accounts / Buyer / Technical Details

Accounts contact name and surname:(Required)
Technical contact name and surname(Required)

Documents Required

Applicable to Close Corporations, Companies and Trusts:

  • Entity's Registration documents
  • VAT registered customers (if applicable):
  • VAT103 – Official notice of registration, OR Tax clearance certificate

Applicable to Individual / Sole Proprietors:

  • Copy of ID document of the applicant
  • VAT registered customers (if applicable):
  • VAT103 – Official notice of registration, OR Tax clearance certificate

Max. file size: 32 MB.
Drop files here or
Max. file size: 32 MB.

    Acknowledgment

    Check(Required)
    Check
    Check
    hereby confirm that:

    • I am duly authorised to enter into this agreement for and on behalf of the applicant, and that the information contained in this form is true and correct.
    • I have read and understood the standard Terms and Conditions of sale and accept them as binding upon the applicant. I furthermore agree to check Headset Solution's Terms and Conditions of sale periodically for changes that may have taken effect from the date of registration.
    • I have read and agree to the processing of personal information in terms of the Protection of Personal Information Act, 4 of 2013 ("Act")
    • I understand that this is a Reseller Registration only and not a Credit Application