International
PhysioTools Reseller Application

Click here to open the application in PDF format.

Company and contact information
Legal company name: Required
Registered name (if different):
Company registration number/VAT number:
Address:
City:
Postal/ZIP Code:
State/County:
Country:
Phone:
Fax:
Email: Required
Web address:
Managing Director/CEO
Phone:
Email:
Sales contact: Required
Phone:
Email:
Tech contact:
Phone:
Email:
Company profile
Company Description (an overview of your company and the services you provide)
1. In which ways do you advertise your products?
(Choose top 3)



Describe Other:
2. What are your target markets?




Describe Other:
3. Which geographic areas do you cover?
4. Do you currently sell software?
If yes, please provide name of software
Financial overview
1. What was your company's total sales revenue for the last 12 months?





2. What is your company's total number of full-time employees?




 
 
 
  
 
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