If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required Full Name * Email * Business Website Address * Address 1 Address 2 City * Country * Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua And Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia And Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, The Democratic Republic Of The Cook Islands Costa Rica Cote D'Ivoire Croatia (Local Name: Hrvatska) Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Timor-Leste (East Timor) Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France France, Metropolitan French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard And McDonald Islands Holy See (Vatican City State) Honduras Hong Kong Hungary Iceland India Indonesia Iran (Islamic Republic Of) Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea, Democratic People's Republic Of Korea, Republic Of Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Macedonia, Former Yugoslav Republic Of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States Of Moldova, Republic Of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Kitts And Nevis Saint Lucia Saint Vincent And The Grenadines Samoa San Marino Sao Tome And Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia (Slovak Republic) Slovenia Solomon Islands Somalia South Africa South Georgia, South Sandwich Islands South Sudan Spain Sri Lanka St. Helena St. Pierre And Miquelon Sudan Suriname Svalbard And Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic Of Thailand Togo Tokelau Tonga Trinidad And Tobago Tunisia Turkey Turkmenistan Turks And Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Viet Nam Virgin Islands (British) Virgin Islands (U.S.) Wallis And Futuna Islands Western Sahara Yemen Yugoslavia Zambia Zimbabwe Zip / Post Code * Phone * I would like to apply for an Affiliate Account only I would like to apply for a Reseller Account Tell us about your business... Identify number of business employees * 1-5 6-20 21-50 50+ Please briefly outline the market sectors in which you operate, and identify these in order of priority/size (1 to 3) as they relate to your organisation’s activities. Market Sector 1 * Arts & Crafts Events Promotion Historical, Tours & Sightseeing Hotels & Restaurants Leisure & Recreation Professional Services/Other Retail/Wholesale Operations Spa’s, Health & Wellbeing Sports Market Sector 2 Arts & Crafts Events Promotion Historical, Tours & Sightseeing Hotels & Restaurants Leisure & Recreation Professional Services/Other Retail/Wholesale Operations Spa’s, Health & Wellbeing Sports Market Sector 3 Arts & Crafts Events Promotion Historical, Tours & Sightseeing Hotels & Restaurants Leisure & Recreation Professional Services/Other Retail/Wholesale Operations Spa’s, Health & Wellbeing Please identify any other market sectors not listed above in which you wish to sign your customers to the VoucherCart platform. How do you plan to promote the VoucherCart platform to your customers? * Please make specific reference to any of the promotion methods below where appropriate. Email Marketing Telesales Networking Advertising Social Media In your own words please briefly describe the VoucherCart system features and benefits as you would convey this to a prospective customer? * Please briefly outline why you are suitable as a VoucherCart reseller? Please do the math: 11 - 4 = * I have read and agreed to VoucherCart Ltd Reseller Agreement terms & Conditions * VoucherCart Reseller Terms & Conditions
