Please complete this form to apply as an Chanimal partner. Please call us at (512)263-9618 if you have any questions.
Contact Information
Company Name
Your Name
Title
Address
City
State
AB AK AL AR AZ BC CA CO CT DC DE FL GA HA IA ID IL IN KS KY LA MA MD ME MI MO MS NC ND NE NH NJ NM NV NY OH OK ON OO OR PA QU RI SC SD TN TX UT VA WA WI WV
Zip Code
Website
E-mail
Phone Number
Fax #
Accounting Contact
Phone
Purchasing Contact
Marketing Contact
Company Classification
Years in Business
Business Type
Corporation
Partnership
Proprietor
Which Distributor(s) do you purchase from:
Ingram Micro
Tech Data
D&H
Navarre
GE Access
Other:
Please provide one distributor account # (used to verify reseller status). Call number above if unavailable.
Name:
Number:
How would you classify your company? (check all that apply)
Reseller
VAR
Sys Integrator
Consultant
OEM
Developer
Chain
Training
Franchise
Distributor
Mail Order
E-Commerce
Select vertical markets you “concentrate” on and specialize in - check all that apply
Government
Education
Fortune 500
Accounting
Advertising
Aviation / Aero
Automotive
Chemical
Construction
Development
Entertainment
Food Services
High Tech
Health Care
Insurance
Library
Publishing
Real Estate
Security
Travel
Other (list):
Prior year annual revenue
Projected revenue this year
Percentage of revenue (totals 100%):
Hardware
Software
Services
What geographical area do you serve?
Local (50 mile)
State wide
Regional
National
International
Total # of employees # Inside sales # Outside sales # Engineers
Indicate which types of marketing activities you engage in:
Seminars
Newsletters
Trade Shows
Direct Response
Print Ads
Relationships, Certifications
Please list other primary vendors you have a formal (reseller agreements) relationship with. Include key certifications.
Please provide a description of your primary “value added” services (integration, training, custom development, etc.)
What other products do you sell that are similar or complimentary to Chanimal or other Chanimal software?
Reseller Agreement (please read)
Click here to view the Chanimal Partner Agreement (opens in its own window).
By submitting this form, I agree to the terms of the reseller agreement.
Please e-mail our Partner Manager if you have problems submitting this form, or you have any questions. If you get additional errors, you are welcome to print this completed form and FAX it to (512)263-9618. Att: Partner Program Manager.
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