Distributor Acknowledgment Form DASEstablishment Name:*Main Contact:*Phone:*Email:* Main Address: *Street Address:*City:*State / Province / Region*Zip / Postal Code*I confirm I have read, having acknowledged and agree to abide by and be bound by the terms and policies of:Authorized* Acknowledge Authorized Reseller Policy (Required) Acknowledge Map policy (Required)CommentsThis field is for validation purposes and should be left unchanged.Δ