Partner Registration Form
Please provide the following information. A NIKSUN representative will contact you shortly. Fields marked by an ‘*’ are mandatory.
Company Information:
Company Name *
Address 1 *
Address 2
City *
State or Province *
Country *
Zip or Postal Code *
Telephone/Fax *
Contact Name *
Email *
Type of Partnership :
Territory:
Industry *
Other
Geography *
Other
Acount Type *
Other
Federal government resellers please Contact GSA@niksun.com
Size:
Annual Revenue $ *
No. of Employees
Sales * Tech Support *
SE’s * Other *
Support Capabilities (to perform Tier 1 and 2):
24 x 7? Yes or No
Support details – Hours, Type
(telephone, on-site, etc.)
Other
Professional Service Capabilities:
Consulting *
Systems Integration *
Project Management *
Business Strategy:
Other products carried
(including competitors)		 *
How do NIKSUN products fit into your business strategy? *
Desired Relationship (Reseller, Integrator,
Sales Representative, Other)		 *
Targeted Annual NIKSUN Revenue *
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