MadCatz Store.

Thank you for your interest in becoming an Authorized Reseller for the new Mad Catz Sports Controller products. Please complete this Application Form to assist us in evaluating your business for the Mad Catz Sports Controller Authorized Reseller Program. This information will be used to make a reseller selection decision. Mad Catz accepts applicants as Authorized Resellers in its sole discretion. Applications will not be processed or considered unless all questions are answered.

Company Information

Company Legal Name:

Company D/B/A:

Reseller Tax Exempt ID:

Address:

City:	State/Province:	ZIP/Postal Code:

Country:

Web Address:

Primary Reseller Contact

Name:

Title:

Phone Number:

Fax Number:

E-mail Address:

Company Profile

Date Established :

Additional Office Locations:

Company's prior year annual sales:

Company's projected revenue for this year:

Number of full-time (W-2) employees

Total:

Sales Reps:

Please tell us why you would like to become a Mad Catz Authorized Reseller and what sets you apart from your competition. (100 words or less).

Click "Submit" when completed to submit application:

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