Kinetix Web Hosting - Resellers programs

Reseller Application

Please fill out the following application. It should take only a couple of minutes to complete. When we have recieved it we will review the information carefully and contact you to take the next step towards becoming a hosting provider.

Company Name
Address
Address
City, State and Zip


Contact Person
Contact Email Address
Contact Phone Number
Type of Business
Years in Business
Package Desired	Webmaster Deluxe Reseller Pro Distributor
Current Number of Sites
Number of sites projected six months from now
Number of sites projected 12 months from now
How soon do you want to start reselling Kinetix Hosting
Please breifly describe any previous experience your comany has provinding web hosting services.
Feel free to add other comments or questions you would like us to answer when we contact you.
By submitting this information to us, you certify that it is correct, and that we may use this information to contact you for the purpose of providing you with hosting services for resale.