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SureID Partner Application
General Information:

Company: Type of Organization:
Address: Number of
Employees:
Address: Number of
Sales Reps:
City: Number of
Technical Engineers:
State:
Zip Code:
Country:
Phone:
Fax:
Website:

Contact Information:

1. Primary Business Contact:

2. Technical Contact:

Name: Name:
Title: Title:
Phone: Phone:
Email: Email:
Mobile: Mobile:
Fax: Fax:
3. Sales Contact:

4. Marketing Contact:

Name: Name:
Title: Title:
Phone: Phone:
Email: Email:
Mobile: Mobile:
Fax: Fax:
 
5. Please list your geographic region of operations:
6. Please list all companies/products you currently represent:
7. Please describe your business and service offering (go to market strategy):
8. Please describe your typical customer profile:
9. Do you serve a specific application area or vertical market industry?
10. Which of the following does your company offer (check all that apply)?
Resell software/hardware Consulting  
Integration services Training  
Helpdesk support 8x5 Helpdesk support 7x24 Project Management

Other   
11. Please list any partnership designations or program certifications          
from Tier 1 VPN/FW Vendors:


12. Identify the quantity of individual technical certifications           
held by members of your technical staff:
13. Comments or questions:


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