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
* Zip or Postal Code
* Telephone/Fax
* Contact Name
* Email
Type of Partnership :


* Industry
* Geography
* Acount Type
Federal government resellers please Contact


* 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.)

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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