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Distributor Partners
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Azalea Reseller Application
To apply to become an Azalea Reseller Partner, please fill out all fields of the form below.
Please allow up to 2 weeks for us to process your application.
(Required Fields Denoted by
*
)
Company Information
*
Company Name:
*
Address 1:
Address 2:
*
City:
*
State/Province:
*
Zip/Postal Code:
*
Country:
*
Phone:
*
Fax:
*
Website:
Sales Contact
*
Name:
*
Title:
*
E-mail:
*
Phone:
Technical Contact
*
Name:
*
Title:
*
E-mail:
*
Phone:
Company Profile
*
Year Company established:
*
Number of office locations:
*
Territory served:
*
Total number of employees:
*
Number of sales representatives:
*
Approximate 2007 sales ($US)?:
*
What is your company's business model?:
Value added reseller
System integrator
Service provider/ISP
Distributor
OEM
Other
(please specify
)
*
What is your company's vertical market focus?:
*
Wireless products you have sold:
*
Current products you sell/deploy:
*
Please list several reference accounts:
*
VAT/Tax ID:
Technical Expertise
*
Number of engineers/technicians on staff?:
*
Do you provide network design services?:
Yes
No
*
Do you provide installation services?:
Yes
No
*
Technical Certifications obtained:
*
What days and hours do you provide customer support services?:
Additional Information
*
What unique value-add do you offer your customers?:
*
Why are you interested in becoming an Azalea partner?:
*
How did you hear about Azalea Networks?:
*
Any additional comments or questions?:
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