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DEALERSHIP AFFILIATION
Fill in the fields to apply for affiliation or you can also print out the form's
printer-friendly version
, fill it out and send it to us.
Customer ID
Customer Type
Company Name/Agent Name/Reseller
Years in Operation
Contact Person/Email Address
Position
Address
Web Address (if any)
Contact Number(s)
Pricing Level
Select One
Exclusive
Non-Exclusive
Consignment
Discount Rate
Select One
50%
45%
40%
35%
Other
Payment Terms
Select One
COD
PDC (15 days)
Others
Other Instructions (please specify)
Required Documents
Business Registration
Business Permit
SEC / BY LAWS, if Corporation
Secretary's Certificate to Sell BLAST prepaid Card
Bank(s) Reference
Signed Reseller Agreement
Information as basis for this site may change without prior notice.
For further inquiries, e-mail us at
help@blast.ph
.
United Network Access, Inc.
4/F, Victoria 1 Building
1670 Quezon Avenue, Quezon City