Partner Application Form
Please fill in the the required information in the fields below. Once
you have done so, click on the "Submit Application" button located at
the bottom of the form.
Contact Information:
Company Name :
Country of Origin :
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaidjan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia-Herzegovina
Botswana
Bouvet Island
Brazil
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African
Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibuti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
Former Czechoslovakia
France
French Guyana
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Great Britain
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldavia
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
Neutral Zone
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Island
Poland
Polynesia
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Helena
Saint Lucia
Saint
Vincent & Grenadines
Samoa
San Marino
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovak Republic
Slovenia
Solomon Islands
Somalia
South Africa
South Korea
Spain
SriLanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Tadjikistan
Taiwan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City State
Venezuela
Vietnam
Virgin Islands(British)
VirginIslands(USA)
Wallis
and Futuna Islands
WesternSahara
Yemen
Yugoslavia
Zaire
Zambia
Zimbabwe
When filling out the various contact information
below, please ensure that the correct primary contact radio button is
highlighted.
Sales & Marketing Contact
This person is to be the desired primary contact
Name:
Title:
Phone:
E-Mail:
Technical Contact
This person is to be the desired primary contact
Name:
Title:
Phone:
E-Mail:
Accounting Contact
This person is to be the desired primary contact
Name:
Title:
Phone:
E-Mail:
Business Profile
Type of Business
CLEC/ISP/Carrier
Consultant
Distributor
Service Provider
System Integrator
Value Added Reseller
Other
Market Focus
CLEC/ISP/Carrier/IOC
LAN Extension
Healthcare
Hospitality
Commercial Property
Residential Property
Higher Education
K-12
Government
Other
Average Annual Revenue
Less than $500,000
Between $500,000 & $1 Million
Between $1 Million & $5 Million
Greater than $5 Million
Total Number of Employees
Less than 50
Between 51 & 100
Between 101 & 500
Greater than 501
Total Number of Technical
Support Employees :