Contact Information:
*First Name:
*Last Name:
*Title:
*Office Phone:
Cell Phone:
*Email Address:

Company Information:
*Company Name:
Federal Tax ID #:

*Company Web Address:

Company Profile:
We are a Sharepoint Developer We are a Dynamics CRM Provider
We are a Managed Services Provider We are a Systems Integrator
We have an outbound sales force

Number of Employees Number of Salespeople

Specific Industries / Markets You Serve:
Accounting Advertising / PR firms
Aerospace Agriculture / Forestry / Fishing
Banking / Financial / Securities Commercial
Communications (telecom, radio, TV) Construction
Education Engineering / Sciences
Government Hospitality
Transportation Insurance
Legal Services Manufacturing
Medical Non-Profit Organizations
Printing / Publishing Public Utilities
Real Estate Research
Retail Wholesale Distribution
Other No Industry Specialization

Services Provided by Your Company:
Application System Design Configuration
Consulting Data Center Construction
Data Center Implementation Managed Services
Security Consulting / Services Business Continuity / DR Services
Financing / Leasing to End Users Help Desk
Implementation Support Maintenance
SaaS Network Design
Network Installation Network Integration
Network Management Project Management
Remote Processing Software Customization
Software Development Systems Analyst
Systems Integration Training
Other

Areas of Interest:
We are interested in Referral Partnership
We are interested in Reselling Co-Branded Services
We are interested in Reselling Private Label Services

Partner Agreement:
I Accept and I am authorized to execute this agreement on behalf of my company.

Non-Disclosure Agreement:
I Accept and I am authorized to execute this agreement on behalf of my company.