Online Application for reseller cash account with Ultrascope Ltd.
 
Contact Name:

Company or Trading Name:

Contact Telephone Number:

Mobile Phone Number:

Email Address:

How do You Generally Intend to pay for Items:
Cheque  Internet Banking

What is your Default Address:
This is where your invoices & statements will be posted if not sent with goods or via email


What is your Default Delivery Address:


How long have you being trading:

Please take a moment to indicate to us your areas you are primarily involved in:

OEM   Reseller   Consultant:   Corporate:   Education: 
E-Tail
Other:

What Price lists would you like to receive
All Price lists & Updates:   Antennas & related products:
Wireless Networking Products: Wired Networking Products:

Are you over 18 years of age:
Yes: No:

Privacy Notice:
The information collected via this online form is only used by members of Ultrascope Ltd & and will not be passed on. This information is not stored on Ultrascope Ltd web server & is stored off site from our web server/s. Ultrascope Ltd  will use your email address as primary contact point for you to receive emails & other such material. 

We are aware that you may be concerned about the privacy and confidentiality of your personal information. We have taken many steps - from both technical and systems perspectives - to ensure that all of your information is well protected, however we also recommend that you do not disclose any loginID's and or passwords given by Ultrascope Ltd to anyone.