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Torne-se Um Parceiro - FORMULÁRIO DE INSCRIÇÃO

All fields with an asterisk (*) must be filled in.

 

GENERAL COMPANY INFORMATION
1. Legal Company Name
Legal Name *  
2. Other names by which your company is known as in business (Doing Business As)
Other Name
3. Corporate Headquarters
Address *  
Suite/PO Box  
City *  
ZIP/Postal Code *  
Province/State *  
Country *  
Web Site
4. Company Description (Please provide a brief description of your company and core competencies)
Description *  
5. How many employees work for your company?
Employees
6. Do you currently purchase through Distribution? *
If yes, please indicate your current/preferred distributor(s):
 
 
7. Reason for enrolling in the Partner Advantage Program? *
 
Comments (Please provide additional information such as the name of an event attended or requesting sales rep etc.)


COMPANY SALES DATA
8. What was your company's overall sales in the last completed fiscal year? *
   


MARKET SEGMENTATION
9. Please specify the geographical areas where your company does business (check all that apply) *
 
10. What percent of your overall sales is sold to the following market segments? *  
Healthcare %
Manufacturing %
Retail %
Commercial Services %
Transportation & Logistics %
Other Market Segments %     Please Specify  


PRODUCTS SOLD
11. Please specify which products the company sells (multiple selection) *












 


CONTACT INFORMATION
12. Application Submitted By (Person to be contacted regarding the program application)
First Name *  
Last Name *  
E-Mail *    
Position/Department  
Address *  
City *  
ZIP/Postal Code
Province/State
Country *  
Telephone *