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Last
First
Title
Name of Business:
Tax I.D. #
Address:
Email:
City:
State:
ZIP:
Phone:
Type of Business:
In Business Since
Legal Form Under Which Business Operates:
Type of Corp:
Corporation
Partnership
Proprietorship
LLC
If Division/Subsidiary, Name of Parent Company:
DNB #
Website:
Name of Company Principal Responsible for Business Transactions:
Title:
AP Contact:
Company Name:
Contact Name:
Account Opened Since:
This Reseller Application and attached Terms and Conditions (together, the “Agreement”) is entered into between the undersigned company or individual(s) (“Applicant”) and GSM Club LLC. For the purpose of obtaining products from GSM Club, Applicant makes the following written statements and GSM Club shall be entitled to rely upon all such statements as being true and correct. By signing this Agreement, Applicant authorizes GSM Club to contact the references to release information regarding Applicant’s business history to GSM Club as necessary for GSM Club to make an informed decision.
Applicant acknowledges that it has read and understands the terms of this Agreement and agrees to be bound by its terms. By signing this Agreement, Applicant expressly agrees to make payment in full to GSM Club for the purchases in accordance with the invoices provided to Applicant by GSM Club. Applicant expressly agrees to the attached Terms and Conditions of Purchase, which are provided with this application titled “GSM Club, Terms and Conditions of Purchase”. Should Applicant default in any such payment, Applicant expressly agrees to pay a late charge on any amounts in default as set forth in the Terms and Conditions of
Rep:
Contact:
Purchase and, at GSM Club’s sole option, all amounts owed to GSM Club by Applicant shall become immediately due and payable. Applicant further agrees to pay GSM Club’s reasonable attorney’s fees and other costs and expenses incurred by GSM Club’s in the collection of any obligation of Applicant pursuant hereto. This Agreement shall become effective when executed by the Applicant.
Applicant hereby certifies that the information furnished under or pursuant to this Agreement is true and correct and that this information is being furnished to GSM Club with the purpose of inducing GSM Club to enter into this Agreement with Applicant, and understands that GSM Club intends rely upon such information as accurate. Applicant certifies that this Agreement (and the representations contained herein) is true, correct and complete as of the date hereof. This Agreement supersedes all other agreements between Applicant and GSM Club relating to the subject matter hereof, whether oral or written.
Applicant Signature:
Applicant Title:
Applicant Name:
Date:
To ensure a seamless enrollment, please provide the following documents with the application.Download Export Questionnaire