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Get started selling DataAlways, apply today
DataAlways Dealer Application
Get on the fast track to your new remote back-up revenue stream. We've made the process fast and easy to become a DataAlways dealer. Questions? Contact our Dealer Services Department:
| * Required Fields |
Business Information:
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| Email:* | |
| Legal Name:* | |
| Trade Name DBA: | |
| Date Established: | |
| Website Address: | |
| Street Address:* | |
| City:* | |
| State:* | |
| Zip:* | |
| Phone Number:* | |
| Fax Number: | |
| Toll Free Number: | |
Billing Information: |
Same as Business Different |
| Street Address: | |
| City: | |
| State: | |
| Zip: | |
| Phone Number: | |
Shipping Information:
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Same as Business Same as Billing Different
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| Street Address: | |
| City: | |
| State: | |
| Zip: | |
| Phone Number: | |
Autorized Purchaser:
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| Name: | |
| Email: | |
| Job Title: | |
| Phone Number: | |
| Cell Phone: | |
| Fax Number: | |
All new Dealer accounts must pay for DataAlways subscription licenses at the time of purchase up to the first
25 licenses. At 26+ licenses, Dealers may apply for net terms and must complete our application for net terms
credit.
Acceptable forms of payment include:
Credit Card (Discover, Mastercard, Visa, American Express or PayPal) |
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| This Company is: | Public Private |
| Stock Symbol: | |
| Parent Company: | |
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| If Private, |
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| this Company is: | |
| State of Inorporation: |
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| Parent Company: | Yes No |
| Parent Company: | |
| Parent Subsidiary: | Yes No |
| Subsidiary: | |
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Customer Agrees to Notify Veraz Information of any changes of ownership of it’s business within ten (10) days to the following address:
Veraz Information, DataAlways Dealer Relations Department, 1961 Concourse Dr., Suite E, San Jose, CA 95131
(List all owners with 25% or greater ownership in business, in order by greatest ownership percentage) |
Owner Information:
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| Name 1: % Ownership: |
| Name 2: % Ownership: |
| Name 3: % Ownership: |
| Name 4: % Ownership: |
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Telephone toll-free: 1-866-4VERAZ1 (1-866-483-7291)
Or: 1-408-435-5444
Fax: 1-408-435-5445
Email: dealerservice@dataalwaysdealer.com |
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Step 1: Review U.S. Dealer Requirements
All DataAlways remote back-up service subscription sales to applicant will be subject to the DataAlways End User License Agreement (EULA) as published on www.dataalways.com at the time of subscription license delivery. A DataAlways Dealer account is required before pricing can be provided and are subject to the DataAlways Dealer Agreement Terms & Conditions.
Step 2: Complete the Application Process
To request a Dealer account, complete the DataAlways Dealer Application Form. It is in PDF format and contains interactive fields that make it easy to type right into the form. You may type information directly onto this form and simply submit it online. Please allow 2-3 business days for processing.
Or, you may download the DataAlways Dealer Application in Adobe Acrobat PDF format, complete it offline and return to us by email, fax or postal mail.
Email: dealerservice@dataalwaysdealer.com
Fax: 1-408-435-5445
Postal Mail:
Veraz Information, Inc.
DataAlways Dealer Relations Department
1961 Concourse Dr., Suite E, San Jose, CA 95131