Business Name

Primary Contact Name

Business Email

Phone Number

Business Address

Type of Business (Retailer, Repair Service, Distributor, etc.)
RetailerDistributorIndependent Repair ServiceChain StoreOther

Business Website or Social Media Link

Type of Consoles Most Commonly Repaired (optional)

Estimated Volume of Repairs per Month (optional)

Partnership Expectations (Please briefly describe what you’re seeking from this collaboration.)

Preferred Method of Communication
EmailPhone CallText MessageVideo Call

Operational Details (e.g., preferred days for pickups, business hours, etc.)

Tax ID or Business Registration Number (We value your privacy. This information remains confidential.)

Attach Relevant Documents (Optional – e.g., Business License, Partnership Proposal)

Special Requests or Considerations