Howard | Technology

Authorized Channel Partners Program Application

( * ) Indicates required field

Company Profile
* Full Legal Name
* AKA/DBA
* Channel Partners Tax Exempt ID#
* Federal Tax ID#
* Business Address
 
* City
* State
* Zip
* Country
* ASCII Member Yes  No ASCII Number
  * ( required for ASCII Members )
 

Sales Contact

Marketing Contact
* Name * Name
* Phone * Phone
* Email * Email

Technical Contact

Purchasing Contact
* Name * Name
* Phone * Phone
* Email * Email
 
 

Business Information
* Number of Stores
* Number of Years in Business
  Number of Employees
* Technical Staff
* Inside Technical
* Outside Sales
* Marketing
* Total
 

Revenue
  Desktops Laptops Servers
* 2012 $ K $ K $ K
* 2013
(Expected) 		$ K $ K $ K
 
Areas of Coverage
* National Yes No
* Regional Yes No
* Local Yes No Within Miles of (City)
 
Current Customer Base
* Large Business
(>=500 employees) 		% * Education
(K-12) 		%
* Medium Business
(100 - 499 employees) 		% * Education
(Hi-Ed) 		%
* Small Business
(10 - 99 employees) 		% * Federal Government %
* State & Local Government % * Consumer / Small %
* Other % * Office %
For channel partners with one or more storefront locations, what percentage of sales are to walk-in customers vs outbound to corporate, government, or education customers?
%
Walk-in
%
Outbound
 
 

Target Industries/Verticals (check all that apply)
Health Care Accounting Communication
Real Estate Legal Insurance
Banking Retail Transportation
Finance Utilities Manufacturing
Other
 
 

Type of Advertising (check all that apply)
Catalog Newspaper Telemarketing
Radio Direct Mail Television
Magazine Do not Advertise
Internet Shopping Engines
(Cnet, Pricewatch, etc.)
Internet
(Banner Ads)
Other
 
 

Internet

Primary website URL:
Do you sell product over the Internet?
YES NO
What percentage of your product sales are over your website? %
 
 

List all websites your company uses to resell product:

Company name Website URL:
 
 

Authorized/Certifications
Please specify other manufacturer authorizations your organization has
Cisco Front Row
Toshiba Vmware
Mimio D-Link
Microsoft Certified Dell
Fujitsu Hewlett Packard
Panasonic Intel Associate or Premier IPD #
Apple
 
Other certifications:
 
 

What Hardware Vendors are you currently using?
What percentage of your business do they currently represent?

Dell % Acer %
H.P. % Own Brand %
Other:
 
 

Administration
* Can your business provide EDI inventory and sales out data?
Yes No
* Briefly Tell Us About Your Company and Your Value Ads
 
 

Completed by
* Name * Email
* Title * Phone
 
  

MORE INFORMATION

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