Reseller Form

Thank you for your partnership! We look forward to connecting.

Fill out the form below with your information and that of the new opportunity.

Reseller Customer ID: Account Name (Reseller Order): Reseller CSM First Name: Reseller CSM Last Name: Reseller CSM Email: Primary Contact First Name: Primary Contact Last Name: Primary Contact Email: Admin Contact First Name: Admin Contact Last Name: Admin Contact Email: Number of Learners: Content Tailoring Packages Needed: Contract Start Date: Contract Term: Auto Renewal: Requested Subdomain: LMS Provider: Emtrain Platform Type: