General DataComm: Partners & Resellers

Distributors & Resellers

Business Partner Program

Your Name:
Company Name:
Mailing Address:
City:
State/Province:
Postal Code:
Country:
Physical Address:(If different)

City:
State/Province:
Postal Code:
Country:
Telephone:
Fax:
E-Mail:
Corporate Officer Contact:
Title:
D & B Number:
Year Formed:
Place of Incorporation:
Annual Revenue (last 3 years):
Percentage of Sales to End Users:	%
Percentage of Sales to Resellers:	%
Total Number of Employees:
Number of Salespeople:
Number of Field Technicians:
Number of Systems/Network Engineers:
Sales Office Locations:

Line Card Profile

Manufacturer	Product Line	% of Total Annual Business
		%
		%
		%
		%
		%

Forecast of GDC Sales - Year 1:
Forecast of GDC Sales - Year 2:
Vertical Market Focus:
Resellers You Compete With:
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