New Client Registration Use this form to request registration as a BlueNova battery installer, reseller or distributer. You will need to provide proof documents for your company before a profile can be created in our ERP system to process estimates etc. Name * First Name Last Name Invalid value Email Invalid value Primary email address for sales related activity Mobile Phone * Code Number Invalid value Mobile phone number Office Phone Code Number Invalid value Office Phone Who Have you been in touch with at BlueNova * -Select- No One - this is my first interaction Anita Anre Carl Christoff Dirk Eduard Eric James Moses Rofhiwa Victor Yvonne Invalid value Products of Interest * MPS - Mobile Power Series RacPower - 52V rack mount batteries HC & BR - High Capacity 1C 52V Batteries HV - High Voltage 400V+ Batteries iESS - Intelligent Energy Storage Systems Invalid value Please select the product or product ranges you are interested in. Business Type * Business Type Solar Installer Electrical Contractor Electrical Wholesaler Web store Electrical or Geen Energy Equipment Distributor IT & Telecommunication service provider Private Individual Invalid value Please select the type of business you are registering. Please note that .... Company Name * Invalid value Please enter your trading name Website Invalid value Your website will be used to validate your eligibility to register as a partner Address * Street Address Address Line 2 City State/Region/Province Postal / Zip Code -Select- Åland Islands Afghanistan Akrotiri Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Ashmore and Cartier Islands Australia Austria Azerbaijan Bahrain Bangladesh Barbados Bassas Da India Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory British Virgin Islands Brunei Bulgaria Burkina Faso Burma Burundi Cambodia Cameroon Canada Cape Verde Caribbean Netherlands Cayman Islands Central African Republic Chad Chile China Christmas Island Clipperton Island Cocos (Keeling) Islands Colombia Comoros Cook Islands Coral Sea Islands Costa Rica Cote D'Ivoire Croatia Cuba Curaçao Cyprus Czech Republic Democratic Republic of the Congo Denmark Dhekelia Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Europa Island Falkland Islands (Islas Malvinas) Faroe Islands Federated States of Micronesia Fiji Finland France French Guiana French Polynesia French Southern and Antarctic Lands Gabon Gaza Strip Georgia Germany Ghana Gibraltar Glorioso Islands Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-bissau Guyana Haiti Heard Island and Mcdonald Islands Holy See (Vatican City) Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Jan Mayen Japan Jersey Jordan Juan De Nova Island Kazakhstan Kenya Kiribati Kosovo Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Navassa Island Nepal Netherlands Antilles Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paracel Islands Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Republic of the Congo Reunion Romania Russia Rwanda Saint Barthélemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands South Korea South Sudan Spain Spratly Islands Sri Lanka Sudan Suriname Svalbard Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand The Bahamas The Gambia Timor-leste Togo Tokelau Tonga Trinidad and Tobago Tromelin Island Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands Wake Island Wallis and Futuna West Bank Western Sahara Yemen Zambia Zimbabwe Country Invalid value Registered Name Invalid value Enter your company's registered name Company Registration Number Invalid value Please enter your Company Registration Number Invalid value Please enter your Company VAT Number SAPVIA Reg No Invalid value Please enter your SAPVIA registration number PV Green card number Invalid value Please enter your PV Green Card registration number Register for quotations and to receive the BlueNova price list * Register Just send information Invalid value Please add scans of or attach the .pdf documents required below to be registered in our ERP system. Bank Letter Choose any file for this field. Please attach proof of account bank letter. Company Registration Choose any file for this field. Attach a copy of your company registration document if not contained in your bank letter VAT Registration Choose any file for this field. Attach a copy of your VAT registration document if not contained in your bank letter Proof of Address Choose any file for this field. Attach a copy of your Proof of Address Submit