United Micro Inc. always welcomes new sales partners! If you would like to become our wholesale customer, please fill out the Reseller Application Form below AND fax your vendor's license to 1-800-853-9595. You also can call us at 1-800-943-7255 or
E-mail us
with your questions. You will have access to restricted area in a minute!
Reseller Application Form
General Info:
Business Name
State License No
License Issue Date
MM/DD/YY
Principle Officer
City of License
State
Phone
(Login ID)
Area code
Phone
Password
Email Address
Billing Information:
Name
(First, Last)
Address
City
State
Zip/Postal
Credit Card Information
Credit Card Type:
Visa
Master Card
Discover
American Express
Exp. Date
MM/YY
Credit Card Number:
Bank Phone Number:
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