Dealer Application Form

To apply for New Magic Dealership please fill out the form below.

A New Magic representative will contact you to discuss or finalise your application. Pricing details and support materials will be provided to successful applicants. If you require more information please call or email [click here for contact details]


	IMPORTANT NOTE : ALL Fields marked with an asterix (*) must be completed for this application to be successfully processed.

	*Company Details :*
	Dealership Name* :		ABN* :
	Years in Business* :		No of Staff* :
	Company Address* :		Suburb/Town* :
	State* :		Postcode* :
	Country* :
	Telephone* :		Facsimile* :
	Website :


	*Contacts :*
	Primary Contact* :		Email Address :
			Mobile :
	Owner/Director/Proprietor :		(if different from Primary Contact)
	Purchasing Officer :		(if different from Primary Contact)
	Additional Contacts (1) :		(e.g. product manages)
	Additional Contacts (2) :


	*Delivery Address* (if different from above)
	Company Address :		Suburb/Town :
	State :		Postcode :
	Country :


	Trade References (please include two trade references)

	company name (01)* :		contact name* :
			telephone* :
	company name (02)* :		contact name* :
			telephone* :


Type of Business (please check all that apply)

Windows PC	Retailer	Corporate Reseller
Macintosh	Government Supplier	Education Supplier

Products you are interested in distributing (please check all that apply)

Newtek Lightwave

Newtek VT[4]/TriCaster

NewTek SpeedEDIT

Sony (Professional)

Sony (Home Studio)

Hauppauge

Blackmagic Design

Convergent Design

Matrox Digital Video

Other

All Groups