DataMagine Partner Application

Full Legal Company Name*
Address:*
City, State, Zip:*
Country:
Web Site:
Year Founded:
Number of Locations:
Number of Employees:	<50 51-250 251-500 501-1000 >1000
Annual Revenue:	$0M - $20M $20M - $50M $50M - $100M $100M - $500M >$500M
Number of Customers:	<10 11-100 101-500 501-1000 >1000
Primary Partnership Contact:
Name:*
Phone:*
Email:*
Financial Contact:
Name:
Phone:
Email:
Primary Sales Contact:
Name:
Phone:
Email:
Primary Services/Technical Contact:
Name:
Phone:
Email:
Describe your primary Business Profile:
Software Developer / Applications Provider / ISV Hardware / Platform Developer, Manufacturer and Provider Consulting Organization / Systems Integrator Third Party Technology Distributor / Reseller of other company's technology
Do you want to sell DataMagine Software as a Reseller, VAR, or Referral Partner?
Reseller VAR Referral Partner
Describe your anticipated level of commitment (check all that apply):
Sales Resources to drive a limited number of DataMagine opportunities Significant Sales & Marketing Resources to drive high volume of DataMagine sales Perform Consulting Services on DataMagine Software
Are you interested in Imbedding, Private-Labeling, Developing-On or OEM-ing DataMagine Software?
Yes No
Which vertical industries do you market your products/services (check all that apply): Manufacturing Retail Distribution Healthcare Banking / Finance Insurance Utilities Government / Public Sectors Transportation / Logistics Other
What other Software Products do you sell today?
What hardware platforms do you support and sell?
Who is your primary hardware and software distributor?
Hardware Distributor:
Software Distributor: