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 Home >> Partners >> Reseller Program Application Form

Please complete the following form with the most accurate data available

All fields are mandatory

Company Information

Business Name:
Web Site URL:
Address:
City:
State/Province:
Zip/Postal: (USA/Canada Only)
 		Country:
Main Phone Number:
(including area code and extension)
 		Number of locations:
Is this the head office location?
Yes No

Contact Information

Primary
First/Last Name:
Title:
Telephone Number/Extension:
Email Address:
Sales Manager
First/Last Name:
Title:
Telephone Number/Extension:
Email Address:
Technical Manager
First/Last Name:
Title:
Telephone Number/Extension:
Email Address:

Company Profile

Year of establishment:
Do you maintain on-hand inventory?
Yes No
Total number of employees:
Total number of sales staff:
Total number of technical staff:
Total annual revenue:

< $1M
$1 – 9M
$10 – 49M
$50 – 99M
$100 – 249M
$250M+
What type of reseller are you?
VAR
System Integrator
Consultant
Retail
DMR
eCommerce
ISP
MSP
Other:
What is your geographical coverage?
Local
Regional
National
International (List Cities)

           

Other:

Distribution Information

Current distributors: (Select all that apply)
Fontel
Ingram Micro
Lex Tec
Synnex
Tech Data
Other:
Other:
Other:
Primary market focus – Organizations with:
1-9 employees
10-25 employees
26-99 employees
100-499 employees
500+ employees

Size of client networks:
1-25 PCs
26-99 PCs
100-499 PCs
500+ PCs
Vertical markets: (Select all that apply)
Education
Finance
Government (Local)
Government (Federal)
Healthcare
Legal
Manufacturing
Real Estate
Retail
Insurance
Other:
What other email archiving products does your organization currently sell?
Barracuda
GFI
Symantec
Other:

Other:

Advertising / Marketing Activities / Authorization / Certification Information

Promotion of products and services: (Select all that apply)
Webinar
Newspaper
Direct Mail
Industry Trade Magazines
Internet
Email subscription list
Radio
Telemarketing
Trade Shows
End user seminar
Do not advertise

Other:

Which trade journals do you read to learn about new technology and industry news: (Select all that apply)
Computer Reseller News
PC Magazine
Systems Integrator Magazine
InfoWorld
PC Week
VAR Business
Network World
Other:
Which Industry Trade Show do you attend: (Select all that apply)
CompTIA
CMP Xchange
Interop
Gartner
None
Other:


What vendor authorizations does your organization hold? (Select all that apply)
Cisco
HP
Microsoft
Novell
Red Hat
SUN
Other:
What technical certifications do your technical staff have? (Select all that apply)
A+
Cisco
HP
Linux
Microsoft
Novell
SUN
Other:

Value Added Services Information

Which value added services do you provide? (Select all that apply)
Network Integration
E-Commerce
Network Monitoring
7x24 Support
Web Design/Hosting
Training
Other:

Vendor Champion(*) information:

First / Last name:
Title:
Telephone Number/Extension:
Email address:

(*) Vendor Champion will automatically be added to our mailing list and must receive our eNewletter

Program Level Information

Which program level are you applying for?
Silver (Minimum of $50,000 in yearly sales) Gold (Minimum of $100,000 in yearly sales) Platinum (Minimum of $300,000 in yearly sales)

Subscription to the freedom9 eNewsletter

Would you like to subscribe to the freedom9 eNewsletter and other communications?

Primary Contact: Yes No
Sales Manager: Yes No
Technical Manager: Yes No
A note on our privacy policy
Personal Information: Your personal information is only collected voluntarily in order to allow us to contact you to provide information regarding freedom9. No information will be collected without your knowledge. freedom9 does not currently share, sell, rent, or give your information to third parties.
Mailing Lists: freedom9 will only send emails and mail-outs to those individuals who have requested to be on the mailing list. If you wish to be removed from any mailing lists, please send an email to requesting to be removed from the mailing list.
freedom9 will review all applications to determine qualification for membership in the Reseller Program. freedom9 will call the primary contact indicated on the form to review your application within two weeks of submission. If accepted, we will provide you with the Program Policies that govern this program. Acceptance into the program will be based on a variety of factors including but not limited to: current distribution needs, the applicant’s territory, infrastructure, target customers, customer service offerings, customer retention programs, and other applicant programs and characteristics.

freedom9 reserves the right to make changes or exceptions to the policies and procedures, or terminate the program or any of the program benefits, at any time at its sole discretion. freedom9 will make every reasonable effort to inform members of any changes to the program at least 15 days in advance. A member may terminate its membership in the program at any time by notifying freedom9 in writing. All membership cancellations automatically annul that member’s participation in and eligibility for sales incentives rewards beyond the cancellation date.

By submission of this application, I certify that all statements contained herein are accurate and complete to the best of my knowledge. Should any information be reported incorrectly, I understand that it may result in immediate termination of membership for my organization.

Application completed by

First / Last name:
Direct phone number:
Email address:


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