Reseller Request Form

Client Information:

Please enter in all jobs separately (do not combine on one form).

* Job Name
* Name of Reseller
* Reseller Email
* Reseller Phone
* Client's Business Name
* Client's Main Contact First and Last Name
* Client's Address
Client's Address 2
* Client's City
* Client's State
* Client's Zip Code
* Client's Email
* Client's Phone
Client's Fax


Please enter the requested software license(s) below:

* License(s)
SIB Standard ($750 Retail. 20 Pages and News only)
SIB Professional ($2500 Retail)
SIB Custom
ProStores Express ($25/mo Retail)
ProStores Business ($50/mo Retail)
ProStores Advanced ($150/mo Retail)
Other (define)
License Details (if Custom or Other specify all tools and details.)


Please enter in all hours requested for each service, even if zero:

 * Project Management (Typically 2 for SIB and 4 for StoreSense)
 * Design Mockup (4 hours per mockup)
 * Design Implementation (Typically 4 hours. Graphics must be supplied in layered Photoshop format.)
 * Training (Typically 2 hours for SIB and 4 for StoreSense.)
 * Support (Support is optional. All email and phone support is billed at normal hourly rate.)


Hosting Contract will be directly with Client (not Reseller) unless otherwise indicated.

* Domain Name(s): Please enter in all domain names that will be hosted at Project A. Note if the domain is a new registration or a transfer of a current domain. Indicate which will have email vs. those 'parked' or set up as redirects to main site. You must also indicate if Project A will need to register the domain name and keep track of its expiration date. All hard costs for domain registration must be paid in advance. Domain registrations are $20 per year plus a one-time setup fee of $15.

Client information for Hosting

Please enter in billing information or indicate that it is the same as above.

* Use Client information above
Yes No 
Client's Company Name
Client's Contact Person's First and Last Name
Client's Billing Address
Client's Billing Address 2
Client's City
Client's State
Client's Zip Code
Client's Current Email
Client's Phone
Client's Fax
* Email Setup: List all initial email accounts (and any aliases) that will need to be setup on domain.
* Pick a username for primary person responsible for site edits
Enter total estimated amount of this contract (what you expect to be billed by Project A for all services related to this project.)
Expected Delivery Date
* Description of Hosting Service (e.g. static HTML hosting, Database Hosting, etc.):
* Monthly Hosting Amount to Bill Client (e.g. $50 per month, billed quarterly.):
Other Amount to Bill Client (e.g. SSL Key for 5 years, plus setup fee.):
* Email of person submitting form

Please review all fields before submitting this form. A 50% deposit on all new jobs is required. Project A will provide you with a written Estimate of the work to be performed. Please note that this form is a request for service only and does not guarantee delivery of requested services.

Project A
5350 Hwy. 66
Ashland, OR 97520 USA
Phone: (541) 488-1702
Hours: Mon-Fri
8am-5pm PST USA

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(541) 488-1702 x101

Support Homepage
Open a Trouble Ticket
(541) 488-1702 x105 or
(707) 623-1896 x105

Main Line:
(541) 488-1702 or
(707) 623-1896
Front Desk: ext. 0
Accounting: ext. 102
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