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Reseller / Independent Rep Application
If you are not yet a registered Mainline Reseller/Independent Representative please complete the form below for detailed information on the unique benefits and structure of our reseller program. Your application will be reviewed within 24-48 hours and if the information you provided meets our basic requirements, you will be sent our IR/VAR program structure and full application



Company :
Address 1:
Address 2:
City :
State :
Zip :
Phone :
Fax :
Cell :
URL :
Contact Name :
Contact Title :
E-Mail :
Please Provide a Brief Description of Your Business :
Federal Tax I.D. #:
Reseller Certif. # :
Dun & Bradstreet#:
Our Market Focus :
Annual Sales :
I am interested in the following product lines : Server Cabinets
UPS Systems
A/C Systems
 Consoles
 Data Safes
 KVM Switching
Computer Equipment
Technical Products
Do You wish Mainline to carry receivables?  Yes    No
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