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infoRouter Partnership Request Form
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infoRouter Partnership Request Form
Partners Application Form
First Name
*
Last Name
*
Title
*
Email
*
PHONE
*
Fax
Company Name
*
Address
*
City
*
State / Province
*
Alabama
Alaska
Alberta
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
Newfoundland
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip / Postal Code
*
Country
*
Canada
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antartica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia-Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote D'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Estonia
Ethiopia
Faeroe Islands
Falkland Islands
Fiji
Finland
France
French Guiana
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey, C.I.
Guinea
Guinea-Bissau
Guyana
Haiti
Heard and McDonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran (Islamic Republic of)
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Dem. People's Rep of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao Peoples Democratic Republi
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Liechtenstein
Lithuania
Luxemborg
Macau
Madagasca
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mexico
Micronesia, Fed. States of
Moldova, Republic of
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherland Antilles
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Samoa
San Marino
Saudi Arabia
Senegal
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Somalia
South Africa
Spain
Sri Lanka
St. Vincent and the Grenadines
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania, United Republic of
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkiye
Turkmenistan
Turks and Caicos Islands
U.A.E.
Uganda
Ukraine
United Kingdom
United States
Uruguay
Uzbekistan
Vatican City State
Venezuela
Viet Nam
Virgin Islands (British)
Virgin Islands, U.S.
Yemen, Republic of
Yugoslavia
Zaire
Zambia
Zimbabwe
Company Profile
*
1-3 years
4-6 years
7-9 years
10+ years
Number of Employees
*
0-4
5-9
10-19
20-49
50-99
100-499
500+
Number of Sales Personnel
*
0-4
5-9
10-19
20+
Number of Technical Personnel
*
0-4
5-9
10-19
20+
Primary Business Model
*
Value-added Reseller
Reseller
Strategic Consultant
OEM
System Integrator
Retailer
E-commerce
Other
What is your main focus ?
*
Vertical Market(s) the Company Targets ?
Aerospace
Accounting
Automotive
Education
Engineering
Financial Services
Imaging
Insurance
Magazines
Manufacturing
Legal
Medical
Multimedia
NewsPaper
Pharmaceutical
Real Estate
Other (please specify)
Comments
*
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