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Welcome to the NASBA Membership Application. If you are not a reseller - you will not be asked to complete an application. Simply provide your basic contact information and we will include you in our non-member database and keep you informed of NASBA activities. If you are a reseller - this Member Application will take about 5 minutes to complete. Your detailed information is greatly appreciated and we sincerely THANK YOU! This data on your company will help us to better serve YOU. Note: Fields marked with an Asterisk* are required. A missed field will be marked in RED. There is an approval process of approximately 24-48 hours to insure that the application is complete. NASBA is committed to protecting your company's profile information. Please review our Privacy Policy below.

General Membership: Applicants must reside in the US or Canada. Reseller IT, CE or AV products. You must also complete this application and update your profile annually.
 Personal Information
*First Name:
*Last Name:
*Email:
*Contact Phone - Full: ( )         Ext. 
  Fax: ( )    
Company Information
Title*
*Web Address/URL:
*General Business Type:
*Company Name:
  DBA 1:
*Address 1:
  Address 2:
*City:
*State/Province:       *Zip/Postal Code:
*Country:
*Main Company Phone: ( )       
*Company Description/Notes:
Note: Questions 1 - 7 below do not need to be answered if you selected Distributor, Vendor, Consultant, Media or Other as your general business type.

1.  Which category best describes your company's primary business?
*Reseller Category Type:  
2.  What % of your annual revenue is derived from the following services?
Consulting: Monitoring:      
Hardware Sales:             Security:
Networking: Storage:
Servers:           
 3.   What % of your annual revenue is derived from the following customer types?
Small Business: Enterprise:
Small Home Office:        Consumers:
Government: Education:
Other:            Please describe:
4.  How many Desktop PC's does your company sell each month? (Last 6 Months Average)
PC's Sold (pick the most applicable):
5.  How many portable, notebook or mobile PC's does your company sell each month? (Last 6 Months Average)
Notebooks or Portables Sold:
6.  How many servers does your company sell each month? (Last 6 Months Average)
Servers Sold:
7.  Which company are your primary and secondary IT product distributors? (Last 6 Months Average)
Primary IT Products Distributor:
Secondary IT Products Distributor:
How did you hear about Nasba?
NASBA members are eligible to receive a complimentary subscription to ChannelPro Magazine. Do you wish to receive a FREE subscription to ChannelPro Magazine? 
A unique personal identifier question is required in order to verify that this subscription request is valid. On what day of the month were you born?
8.  Nasba privacy policy and terms of use
By submission of this Application, I certify that all statements contained in this Application are accurate and complete to the best of my knowledge. Should any information be reported incorrectly, I understand that it may result in my termination of Membership for my company.

Acceptance into this program will be based on a variety of factors. NASBA reserves the right to make changes to, make exceptions to, and terminate services, or any of the member benefits, policies and procedures, at any time in its sole discretion. NASBA will make every reasonable effort to inform you of any changes to your membership program at least 15 days in advance. A member may terminate its membership in the Program at any time by notifying NASBA in writing.

If accepted, we will provide you with a NASBA account number. This number is used for a variety of things in the organization.
(NASBA Privacy Policy)
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