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Partner ProgramApplication

All information will be held in strict confidence and is used solely for the purpose of evaluation.

Company Contact Information

Company Legal Name
Application Contact
Office Mailing Address
Address Line 2
City
State
Zip Code
Phone Number
Fax Number
E-Mail
URL

Company Classification

Years in Business
How would you classify your company?
(check all that apply)
Reseller VAR
Systems Integrator Consultant
Developer Distributor
Other
List any vertical markets that you service
(comma separated list)
Prior year annual revenue
Projected revenue for this year
Percentage revenue
Hardware
%
Software
%
Services
%
What geographic area does your organization serve?
Local (50 mile radius) National
Regional (300 mile radius/up to 5 states) International
Total number of employees
Approximate number of employees that would sell and service
Full-time inside sales people 
Outside sales people 
Full-time pre-sales engineers 
Post-sales engineers 
Indicate what types of marketing activities your company engages in
(check all that apply)
Newsletters Seminars
Trade Shows Direct Mail
Print Advertising
Other
Please list software vendors, hardware vendors, consulting firms and/or systems integrators with whom your company has a formal business relationship. Include any existing certificates (i.e. Microsoft Solutions Provider Partner, Cisco Certified, Novel Platinum, etc.)
Please provide a description of value-added services that your company offers (i.e. reseller of software, network integration, custom development, training, installation)
Please provide a list of any products that you sell that might compete with MIE