The Lead Generator VAR Program

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VAR / Rep Application Form

First Name, Last Name
Company
*Address
City, State/Province
Zip/Postal Code Country
*Email Address
*Telephone Number
*EIN/SSN	(?) Note that Partners/VARs for the Lead Generator are defined by the IRS as Independent Contractors. This means that you should operate as a business, and have a valid Employer Identification Number (EIN). If not, we can use your Social Security number (SSN). For more information, and to get an EIN, please click here.
Master Agent	(if known)

By clicking on the Submit button, you acknowledge that you have read, understand, and will abide by the
terms and conditions of the Sales Agency Agreement, and will sign and send same to JV/M at the address below.

The Lead Generator is a service of LeadGen.com and JV/M, Inc.
1221 N Church Street, Suite 202 • Moorestown, NJ 08057
856-638-0399 • info@JVMinc.com