Become a Dealer!

1SourceVideo is always on the lookout for motivated companies that recognize the value of the manufacturers and products we bring to the video and animation marketplace. If you would like to become an authorized 1SourceVideo Dealer, please complete the following form.

The submission of this application does not warrant or guarantee approval to become an authorized reseller for any of the manufacturers that 1SourceVideo represents. Once your application is submitted, it will undergo an approval process to verify whether your company meets and can sustain 1SourceVideo's dealer criteria. The review and decision process can take up to 30 days. All applicants will be notified once a decision has been made.

This application is designed to obtain information about your company for dealer approval. This information is strictly confidential, and will be used only in the alliance between 1SourceVideo and your company. At the conclusion of submitting the form, you will be asked to attach a copy of your current financials, a copy of your certificate of incorporation, a picture of your brick and mortar store front, and any other relevant documents you deem appropriate.

Do you need the W9 form? Download the W-9 PDF version

If you have trouble submitting this form? Download the PDF version and mail / fax us your information.

Want to sell NEWTEK? Fill out NEWTEK Dealer Application

Want to sell BlackMagic Design? Fill out BlackMagic Design Dealer Application

Need a Resale Tax Form for your State? Download Your State Resale Form.

Applicant Information

*(denotes required field)

First Name: *

Last Name: *

E-Mail Address: *

General Information

Company Name *

Company Street Address *

City *

State *

Zip *

Telephone *

Fax

Website Address

Proprietorship, Partnership, Corporate Information

Business Identity (dba) *

E-Commerce URL Address

Federal EIN, Business ID or Social Security No. *

Resale Certificate / Permit No.

Resale Certificate Expires

D&B No. (if applicable)

Legal Business Formation

Corporation
LLC
Sole Proprietorship
S-Corp
Other

Type of Business?

Reseller
System Integrator
VAR
Pro Equipment Rentals

Will your company ever require an SDK (Software Developer's Kit from any of our manufacturers?

Yes
No

If yes, please indicate which ones

Business Information

Years in Business?

Number of Employees?

Have you or any of your affiliates filed bankruptcy?

Yes
No

If bankruptcy was filed, state year.

Trade 1 Reference

Trade 1 Name

Trade 1 Contact

Trade 1 Phone No.

Trade 1 Relationship

Trade 1 - Years of Business Relationship

Trade 2 Reference

Trade 2 Name

Trade 2 Contact

Trade 2 Phone No.

Trade 2 Relationship

Trade 2 - Years of Business Relationship

Trade 3 Reference

Trade 3 Name

Trade 3 Contact

Trade 3 Phone No.

Trade 3 Relationship

Trade 3 - Years of Business Relationship

Bank Reference

Bank Name

Bank Street Address

Bank City

Bank State

Bank Zip

Bank Phone

Bank Account Number

Company Principals

Name 1

Title 1

Name 2

Title 2

Name 3

Title 3

Company Contact - President (Name, Email Address)

President Name

President Email

Authorized for Pricing Updates

Yes
No

Authorized for Product Updates

Yes
No

Authorized to Order Online

Yes
No

Company Contact - Vice President (Name, Email Address)

Vice President Name

Vice President Email

Authorized for Pricing Updates

Yes
No

Authorized for Product Updates

Yes
No

Authorized to Order Online

Yes
No

Company Contact - Sales Manager (Name, Email Address)

Sales Manager Name

Sales Manager Email

Authorized for Pricing Updates

Yes
No

Authorized for Product Updates

Yes
No

Authorized to Order Online

Yes
No

Company Contact - Purchasing/Buyer (Name, Email Address)

Purchasing/Buyer Name

Purchasing/Buyer Email

Authorized for Pricing Updates

Yes
No

Authorized for Product Updates

Yes
No

Authorized to Order Online

Yes
No

Sale Personnel (Name,Email Address)

Name/Email

Name/Email

Name/Email

Name/Email

Name/Email

Name/Email

Additional Company Information

Is your company capable of EDI?

Yes
No

What was your sales volume in 2011?

What was your sales volume in 2011?

What was your top selling product in 2011?

Please describe your geographic territory.

1 Source Video Vendor Choices

Which 1SourceVideo Vendors suit your company profile?

AVID
Bella Corporation
Blackmagic Design
Class on Demand
Cineform
Cubix
Davinci
DigiEffects
Dulce Systems
E-Films
imagineer systems
NewTek
ProAvio
Red Giant Software
Softron Media Services
Sony
Supermicro Computer Inc.
Tangent Devices

Partner Marketing Opportunities

What 1SourceVideo related marketing activities will/would you run in a year?

Seminars
Open House
Direct Mail
Other

How will you train your staff to sell 1SourceVideo Products?

In-House Training
Online Training
Product Tutorial
NewTek Sponsored Training
Contractor
Other

Do you currently stock product in your storefront?

Yes
No

Personal Signature

Name

Title

Phone

Email

Company Financial *

Acceptable file types: doc,pdf,txt,gif,jpg,jpeg,png,docx.
Maximum file size: 5mb.

Certificate of Legal Business Entity *

Sales Tax Form *

Picture of your storefront

Other

Any final comments to send?

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