Partnership Agreement Form | Digital Transformation and Digital Marketing Services

Name *

First

Last

Job Title *

Company *

Email *

Phone *

Address *

Address Line 1

City

State / Province / Region

Postal Code

Country

No. of Full-Time Employees *

No. of Sub-Contractors *

Years in Business: *

Annual Sales (USD): *

What Services Do You Provide? (Please check all that apply) *

How do you anticipate partnering with Density? *

Please list your top 5 customers in terms of revenue *

Please provide details on your service areas (region, etc.). *

I HAVE READ AND ACCEPT THE TERMS OF THE SAFESPACE RESELLER AGREEMENT.

By submitting this application, I acknowledge that I am authorized to enter into this Reseller Agreement on behalf of the legal entity shown on the Reseller Application and thereby to bind such entity to the terms of the Reseller Agreement