ION Computer Systems

	ION Computer Systems Reseller Application

Primary Contact
Company
Address
Address2
City	State Zip
E-Mail
Telephone Number	Fax Number

A/P Contact
A/P Phone	A/P Fax
Sales Tax Resale ID:
D & B Number:
Company Web Site:
Authorizations	Intel Partner Alliance. IBM HP Microsoft Certified Partner Lenovo Red Hat Certified Reseller
Additional Information
How do you plan to pay for your purchases?
	Credit Card
	Wire Transfer in Advance or Check in Advance
	On my ION Corporate Account


	Trade References
Company 1:
Address 1:
City 1:	State 1: Zip 1:
Credit Rep. 1:
Telephone Number 1:
Credit Limit 1:	Terms 1:
Account Num. 1:


Company 2:
Address 2:
City 2:	State 2: Zip 2:
Credit Rep. 2:
Telephone Number 2:
Credit Limit 2:	Terms 2:
Account Num. 2:


Company 3:
Address 3:
City 3:	State 3: Zip 3:
Credit Rep. 3:
Telephone Number 3:
Credit Limit 3:	Terms 3:
Account Num. 3:


	Bank Information

Bank Name:
Address:
City:	State: Zip:
Telephone Number:
Account Number: