Entrust Datacard PartnerPlus Registration
Please fill out the form below to apply to our Channel Partner Program.
Basic Company Information
- Company Legal Name: *
- Company URL: *
- Address: *
- Address 2:
- City: *
- Country: *
- State / Province: *
- ZIP / Postal Code: *
Company Description: *
Business Details
Partner Capabilities for Entrust Datacard Products: *
- Company Size
(Total Revenue): *
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Top Vertical Markets: *
- Current Solutions Offered:
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Entrust Datacard Solution Interest: *
Company Staffing
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Geographic Coverage
(and Vertical Market Focus, if applicable) |
- Number of Salespeople: *
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- Outside Salespeople: *
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- Inside Salespeople: *
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- Telemarketing: *
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- Technical Support: *
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- Professional Services: *
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- Marketing: *
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Registration Information for Legal Agreement
- Incorporation of Business Location : *
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(State/Country)
- Territories of Coverage by Country: *
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(ex: North America or country name(s))
- Agreed Annual Sales Quota (if applicable):
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Contact Information
Primary Contact:
- First Name & Last Name: *
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- Email: *
- Title: *
- Phone: *
- Mobile:
- Fax:
Authorized Contact for Agreement Signature
- First Name & Last Name: *
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- Email:*
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- Title:*
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- Phone:*
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- Fax:*
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Privacy Statement: *
Submit Application