*
= required
1. Company Overview
Business Name
*
Trading Name
Address Line 1
*
Address Line 2
Address Line 3
Town
*
County
*
-- Please Select --
Aberdeenshire
Angus
Antrim
Argyll & Bute
Armagh
Avon
Bedfordshire
Berkshire
Blaenau Gwent
Borders
Bridgend
Bristol
Buckinghamshire
Caerphilly
Cambridgeshire
Cardiff
Carmarthenshire
Ceredigion
Channel Islands
Cheshire
Clackmannanshire
Conway
Cornwall and the Isles of Scilly
County Durham
Cumbria
Denbighshire
Derbyshire
Devon
Dorset
Down
Dumfries & Galloway
East Ayrshire
East Dunbartonshire
East Lothian
East Renfrewshire
East Riding
East Sussex
Edinburgh
Essex
Falkirk
Fermanagh
Fife
Flintshire
Glasgow
Gloucestershire
Greater Manchester
Gywnedd
Hampshire
Herefordshire
Hertfordshire
Highlands
Inverclyde
Isle of Anglesey
Isle of Man
Isle of Wight
Kent
Lancashire
Leicestershire
Lincolnshire
London
Londonderry
Merseyside
Merthyr Tydfil
Midlothian
Monmouthshire
Moray
Neath Port Talbot
Newport
Norfolk
North Ayrshire
North Lanarkshire
North Yorkshire
Northamptonshire
Northumberland
Nottinghamshire
Orkney Islands
Oxfordshire
Pembrokeshire
Perth & Kinross
Powys
Renfrewshire
Rhondda Cynon Taff
Rutland
Shetland Islands
Shropshire
Somerset
South Ayrshire
South Lanarkshire
South Yorkshire
Staffordshire
Stirling
Suffolk
Surrey
Swansea
Torfaen
Tyne & Wear
Tyrone
Vale of Glamorgan
Warwickshire
West Dunbartonshire
West Lothian
West Midlands
West Sussex
West Yorkshire
Western Isles
Wiltshire
Worcestershire
Wrexham
Post Code
*
Company Registration Number
*
fixITlocal line
*
Contact Number
(landline)
*
Contact Number
(mobile)
Fax Number
*
Website Address
Turnover
(last years figures)
*
Number of locations
0
1
2
3
4
5
6
7
8
9
10+
What services do you offer?
*
Tick all that apply
Repairs and upgrades
Hardware installation
Software Installation
Network setups (including wireless)
Protection & security
Voice over IP
Home entertainment setup
Back up and data recovery
Would you like to receive enquiries from?
*
Tick all that apply
Consumer
Business
PC
Mac
Primary Contact Details
*
First Name
*
Surname
*
Email
*
Secondary Contact Details
First Name
Surname
Email
2. fixITlocal Network
To be able to route calls through to you, you will require one of your phone lines to be part of the fixITlocal network. Please read and select one of the following options:
Standard Membership - £15 per month
Calls are diverted to you by customers using the 0844 services utilising one of your existing lines.
Please sign me up to the standard membership
Offer 1 Membership - £35 per month
Includes line rental, daytime, local and national calls. Monthly fixITlocal membership.
Please sign me up to Option 1 membership
Offer 2 Membership - £40 per month
Includes line rental, all daytime, local and national calls. Monthly fixITlocal membership and 8Mb broadband.
Please sign me up to Option 2 membership
3. Service Module
Fixitlocal resellers can register to receive service and installations calls, These are allocated by the Vendors or Automatically by nearest search. To accept calls you must provide an email address where the calls will be sent and a mobile number to receive an SMS call alert. To accept a call you must respond within 4 hours.
Email address for Service Alerts
Mobile Number for SMS alerts
Service Vendors
Please tick each one you want to receive calls from.
*Cerco require resellers to be authorised.
Burnetts
Cerco*
Mesh
Senior Alliance
4. Trade Association
To ensure customers get a high level of service and give you a selling advantage, fixITlocal require that all resellers who register for the programme are a member of
either
the PCA or MTA and agree to conform to the Code of Practice.
Please select below if you are a paid member of the Professional Computer Association (PCA) or Mac Technology Association (MTA)
*
PCA
MTA
Both
Neither
If you are a member of one or more of the above please go to section 4.
i) Please sign me up for the
PCA membership
(£50 per year).
I agree to be bound by the code of practice and the rules of the association.
Click here
to view.
OR
ii) Please sign me up for the
MTA membership
(£50 per year).
I agree to be bound by the code of practice and the rules of the association.
Click here
to view.
GFK Reseller Panel
In
addition
to the PCA/MTA membership you are also able to sign up to be part of the GFK Reseller Panel. Once you are a panel member you will receive a variety of market information reports from GFK which will keep you up to date on the state of the IT market in the UK and on the state of the UK economy in general. GFK are offering PCA members a £25 rebate off membership.
Please
Click here
to view details and sign up.
5. Special Deals
Special deals are being provided by Northamber Plc and Micro-P who will
contact you regarding their fixITlocal programme.
6. How did you hear about fixITlocal?
Please select an option from the list provided
*
-- Please Select --
Brigantia
BT
Computer Reseller News (CRN)
DMSL
fixITlocal Telemarketing
fixITlocal Website
fixITlocal-eshot
Fujitsu
Micro-P
Microscope
Microsoft
MTA-Mac Tech Ass
National Press
Northamber
PCA-Prof Comp Ass
Search Engine
Trade Press
Trusted Reviews
Website
Other
7. Reseller Profile
Total Number of People Employed
Total: All employees
-- Please Select --
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
25+
Total: Technical
-- Please Select --
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
25+
Main Business Channel
(tick as many as relevant)
Consultant
Data Specialist
IT High Steet Retailer (Computers/Printers/Storage)
IT Reseller (Computers/Printers/Storage)
Office Equipment Reseller (Furniture/Stationery/Photocopiers)
Service Company
Voice Specialist
Web based Sales Company
Geographical Locations Covered
Local
National
Customer Profile Sectors
(tick as many as relevant)
Central Government
Consumer
Education
Finance
Local Government
Manufacturing
Retail
Service
SME’s
Accreditations
(tick as many as relevant)
Apple
BT
Microsoft
Please confirm to accept our
Terms and Conditions
.
If you have any queries regarding this form, please contact the Reseller Sales Team on
01708 776 005
or email
resellers@dmsluk.co.uk
FixITLocal is a wholly owned subsidiary of DMSL Ltd.