ZCHPC RESELLER APPLICATION fORM
SECTION 1: COMPANY DETAILS
Company Name:
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Business Registration Number:
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Tax Clearance Number (TIN):
*
Physical Address:
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Physical Address:
*
Postal Address (if different):
*
Contact Person Name & Title:
*
Email Address:
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Phone Number(s):
*
Website URL:
*
Type of Entity:
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Private Limited Company
Partnership
Sole Proprietor
NGO
Government Entity
Other
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SECTION 2: COMPANY PROFILE & CAPACITY
Core Business Activities:
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Years in Operation:
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Number of Employees:
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IT Technical Certifications or Partnerships (if any):
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Do you currently resell other technology or cloud services?
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No
Yes
If Yes Explain
Do you currently resell other technology or cloud services?
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Yes
No
If yes, please specify
Relevant Industry Experience or Projects Delivered:
*
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SECTION 3: PROPOSED RESELLER SCOPE
1. Which ZCHPC services do you intend to resell? (Tick all applicable):
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Cloud Computing Services
Data Centre Hosting
HPC Compute Time
Storage Services
Backup & Disaster Recovery
HPC Software & Licensing
Training and Capacity Building
Other
2. Target Market Segments (e.g. SMEs, Government, Education,NGOs):
*
3. Geographical Focus:
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National
Regional
Specific Provinces:
4. Expected Monthly Sales/Leads:
*
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SECTION 4: LEGAL, FINANCIAL & DUE DILIGENCE
Attach the following mandatory documents:
1. Company Profile
*
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2. Certificate of Incorporation
*
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3. Current Tax Clearance Certificate
*
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4. CR14 or Current List of Directors
*
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5. Certified Copy of Company Bank Statement (last 3 months)
*
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6. Trade References (at least 2)
*
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7. Proof of Address
*
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SECTION 5: DECLARATION
I/We hereby declare that the information provided above is true and correct the best of my/our knowledge. I/We agree to abide by the terms and conditions set forth by the Zimbabwe Centre For High Performance Computing (ZCHPC) upon successful appointment as a reseller.
Name:
*
Designation:
*
Signature
*
Date
*
-
Month
-
Day
Year
Date
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