In order to purchase software directly from Domain Entertainment^™ for resale, resellers must meet the following requirements:
 

	Be an ISO/MSP/RA capable of supplying merchant accounts to customers.
	Provide your own customer setup and training, and front-line technical support.
	Purchase in quantities of at least 20 units at a time.
	Hold a valid state reseller sales tax certificate.

If you meet the above requirements please fill out the following required form(s) and you will be contacted by voice or e-mail.

    First Name: 

     Last Name: 

         Title: 

       Company: 

       Address: 

          City: 

         State: 

           Zip: 

         Voice: 

           FAX: 

        E-mail: 

           URL: 
  

Program(s) Currently Sold: 
  
         Units/Month Sold: 
  
       Your Per Unit Cost: 

Total Accounts/Month Sold: 

What clearing houses do you use? (Check All that Apply)
FDR MDI ECHO Other - Specify: