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To become a Kyocera Registered Reseller and be a part of the Channel Partner Program please fill in the application below:-

Club Kyocera Registration

* indicates mandatory information
Salutation *
First Name*
Last Name *
Date of Birth (dd/mm/yyyy) *
Company Name *
ABN Number (No spaces) *
Address *
Suburb/City *
Postcode *
State *
Country *
Phone *
Fax
Mobile
Email Address *
Dealer or Reseller?* Dealer Reseller
If Reseller, who is your main distributor? *
Are you a member of the
Qantas Frequent Flyer program?*		 Yes No
If you are a member you must include the following membership information:
QFF Membership Number*
First Name on QFF Card*
Surname on QFF Card*
Read and Agreed with the Terms and Conditions?* Yes No