Partner Application Form

Business Partner Application - Consultant / Integrator Please fill out the form below as completely as possible : Business Information
Business Name:
Address 1:
Address 2:
City:
State/Providence:		Zip Code:
Country:
Phone Number:
Fax Number:
Website Address:
Number of Employees:
Number of Employees Dedicated to Selling PTS Products:
Partnership Level Requested
Partnership Program Requested:	Strategic Consulting Partner
	Consulting Partner
Primary Contact Details
First Name:
Last Name:
Address 1:
Address 2:
City:
State/Providence:		Zip Code:
Country:
Phone Number:
Fax Number:
E-mail Address:
Marketing and Sales Details
Please briefly describe your businesses market focus:
Annual Sales:
% Service and Software Sales:
% Hardware Sales:
Please list the top four vertical markets the company sells to:
1:	% of Sales:
2:	% of Sales:
3:	% of Sales:
4:	% of Sales:
Please list the top two sales channels: (e.g. sales reps., internet )
1:	% of Sales:
2:	% of Sales:
Geographic Focus: Please list the geographic regions the company supports.

Technical Scope: Please list the platforms, databases, and software systems the company is qualified to integrate with and support.