Reseller Application

Fill out the form below to become a reseller of OffGrid's products

First Name (required)

Last Name (required)

Email (required)

Phone (required)

Website (required)

Company / Department (required)

Company Address (required)

Tax ID (required)

Resale Number (required)

Number of years in business

Number of sales support staff

Geographic areas covered (States/Regions/Countries) (required)

Market Segments Covered

Current product lines distributed (required)

Please describe your business objectives and level of commitment to our product line