VIP+ Partner Registration - DEU
D-Link

Please complete the following form to apply for the D-Link Value in Partnership+ program. Page 1 of 3
Contact Information
Prefix:*
Firstname:*
Lastname:*
Job Title:*
Email:*
Telephone:*

Company Information
Company:*
Address 1:*
Address 2:
Town/City:*
State/Province/Region:
Zip/Postal Code:*
Country:*
Telephone:*
Website (e.g. www.dlink.com):

Total Number of Employees:*
What is your primary territory focus:*
Reseller Tax ID / VAT:*
Type of Business:*
Fields marked with * are mandatory
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