Please read all the program rules before completing the application. Once you have submitted this application you will be contacted by our Qreseller Program representative to verify all information and to get you started as BenQ's reseller member and enjoying all the benefits.

Please note: each field marked by an asterisk ( * ) must be completed in order for us to process your application.

* Required  
   
 

Your Company
 
* Company Name:
* Address:
* City:
* State:
* Zip Code:
* What is the function of this location:
   
  URL:
      Example: www.BenQ.com
   
 
   
  Your Business License
 
* (FOR NH, OR, DE - Please use phone# in place of Permit#)
I HEREBY CERTIFY: That I hold a valid Reseller Permit No. # State/Province: issued pursuant to the Sales and Use Tax Law; that I am engaged in the business of selling: .

* My Permit will expire on:
       Month    -    Day    -    Year
   
   
 
   
 

Primary Contact
 
* First Name:
* Last Name:
  Title:
   
  Phone
* Phone: -
  Phone Ext.:
  Fax: -
   
* E-mail:
* Password:
* Password - Verify:
   
 
   
   
* Resale Information form
 
Download the PDF Form

Please fill in the Resale Information Form and print a copy for yourself to sign and FAX it to 949-623-0760. A BenQ representative will contact you to obtain a signed copy of Resale Information Form. BenQ will collect sales tax from resellers who are not able to provide
   
   

Mailing List
 
Yes No

From time to time BenQ may send you E-mail regarding BenQ products, services and special offers. If you do not want to receive such messages, please select "NO" from the buttons above.
   
   
   
 
* I agree to the Qreseller Program Rules & Usage Guidelines
  By clicking the submit button below you agree to the above terms and conditions of the BenQ Qreseller Program, General Rules of the BenQ Qreseller Program, Lead Referral Program Rules and Demonstration Unit Program Rules: