Registered IT Service Provider Application Form

To apply, please complete the below form. Fields marked with * are mandatory.

Company Details

General

Businesss Name*:
Phone*:
Website:
ABN:
Fax:
Email*:

Street Address

Street Address*:
State*: Postcode*:

Postal Address

Same as street address?
Postal Address*:
State*: Postcode*:

Contact Details

Personal

First Name*:
Email*:
Mobile:
Last Name*:
Landline:

Additional Support Personnel

How many additional support personnel
are within your company?:

Customers

Current Customers

Please enter the name of each of your customers currently using a HCN product:
Customer Name*:
Customer Phone*:

Finish

Benefits

Upon registration completion, you will have access to the following benefits:
Technical Knowledge Base HCN Technical Training Videos
HCN Technical and Product Email Communication  HCN Downloads Access

Terms & Conditions

1. Overview

This Agreement contains the complete terms and conditions that apply to you when joining HCN as a Registered IT Service Provider. The purpose of this Agreement is to established terms and conditions relevant when entering into a partnership between you and Health Communication Network (HCN).

This agreement commences when we notify you via email the details in how to access your Registered IT Service Provider benefits. By participating in this program, you represent to us that you agree to be bound by these Terms and Conditions. These Terms and Conditions make up a legally binding agreement for your participation in the HCN Registered IT Service Provider Program.


2. Definitions;
  1. "we," "us," and "our" refer to Health Communication Network (HCN).
  2. "you", "your", "partner" and "yours" refer to the main contact and person mentioned on the HCN Registered IT Service Provider Program application form and the company they represent at time of active employment.
  3. "HCN", Health Communication Network, the company hosting and offering the opportunity to join the Registered IT Service Provider Program.
  4. 'Shared customer', A business whom uses both yours and HCN's services to operate.

3. HCN Registered IT Service Provider Obligations
  1. Acceptance to the HCN Registered IT Service Provider Program shall not constitute any appointments of employment or agency by HCN and save for the specific rights conferred by this Agreement no further special rights or legal relationship shall be bestowed upon You as a result hereof.
  2. You acknowledge that HCN Registered IT Service Provider Program is granted to you, the company you represent at time of active employment and completion of the HCN Registered IT Service Provider Program application form.
  3. That the HCN Registered IT Service Provider Program is an information and knowledge based service only, that no person within the company you represent or affiliate to you in any way may represent themselves as a HCN Registered IT Service Provider.
  4. Where work is carrying out by third parties, there must be no affiliation to the HCN Registered IT Service Provider Program.
  5. To use your best efforts to completely satisfy all reasonable shared customer requirements and where necessary communicate with HCN to achieve the best outcome for our shared or prospective customers.
  6. To provide a positive contribution to all shared customer activities and forbear from any form of communication critical of HCN or its software products.
  7. HCN Registered IT Service Provider Program agrees to satisfactorily respond to any complaints made to HCN concerning the provisioning of your services within 14 days.
  8. You shall in the description, recommendation or demonstration of any HCN product or service to a potential purchaser work closely with HCN to ensure information delivery is true and accurate.
  9. You shall not make any representation on your own account concerning the function or operation of a HCN product or service.
  10. Not do or suggest any conduct to the client that will diminish the value of or attempt to replace or undermine the client paying for HCN Support.

4. Indemnification

You hereby agree to indemnify and hold harmless Health Communication Network from any and all actual or alleged claims, demands, causes of action, liability, loss, damage, judgments and/or injury (to property or persons, including without limitation wrongful death), whether brought by an individual or other entity, or imposed by a court of law or by administrative action of any federal, state, or local government body or agency, arising out of or incident to any acts, omissions, negligence, or wilful misconduct of yours, other personnel, employees, agents, contractors, or volunteers in connection with or arising out of your actions. This indemnification applies to and includes, without limitation, the payment of all penalties, fines, judgements, awards, decrees, attorney fees, and related costs or expenses, and any reimbursements to you for all legal expenses and costs incurred by it.


5. Miscellaneous

This Agreement shall constitute the entire agreement between the parties and may not be varied save by written agreement of the parties. Its implementation shall be governed by the laws of the state of New South Wales and any action arising from its operation shall be heard in Sydney. No course of conduct or inaction by HCN herein shall be deemed as waiver of any of its rights under the Agreement.

I have read and agree with the HCN Registered IT Service Provider Program terms and conditions. I declare that the information supplied in the application is true and correct.*