Request to become a Certified PrivateEZ Service Provider

If you think it's the right time for PrivateEZ, and want to become certified, you are in the right place. Just fill out the simple form below to get started.

We will send you detailed information about the entire program, including our referral program and how that can help defer costs or even generate passive income for your organization. Being first in your area definately has an impact on revenue potential, so if you are interested, don't wait.

Promo Code * If your inquiry results in a purchase, a promo code is required for a 10% discount (applies only to fees charged directly by PrivateEZ). It helps you and the PrivateEZ licensee who provided you with the code. If you don't have one, you may use the ID from any licensed account in PrivateEZ. All QR badges issued by the system include an ID like this: id=94Z0-63A0-31N0. If you want the discount but don't wish anyone to have the credit, enter '0000-0000-0000'	Required for a 10% discount (applies only to fees charged directly by PrivateEZ). Format: XXXX-XXXX-XXXX
Email *
First Name *
Last Name *
Country *	-- Select Country -- United States Canada United Kingdom Australia Germany France Other
State / Province *	-- Select Country First --
Address *
City *
Postal Code *
Company / Organization *
Title *
Phone *
Website *
Authorization *	I authorize PrivateEZ to contact me with information about the certification program, referral program and related opportunities.
Terms of Service and Privacy Policy	By submitting this form you accept the Terms of Service at tos.php and the Privacy Policy at privacy.php.
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