|
Step 1: Please enter your company Contact information.
|
|
Fields with an asterisk (*) are required
|
|
* Name :
|
|
|
Your title :
|
|
|
* Company :
|
|
|
* Email :
|
|
* Address :
(Please NO PO Boxes.)
|
|
|
|
|
* Country :
|
|
|
* State/Province :
|
|
|
* City :
|
|
|
|
|
|
* Zip Code :
|
|
|
* Phone :
|
|
|
Fax :
|
|
|
* What is your WWW address? :
|
|
|
|
|
|
|
|
|
Step 2: Please enter your company's business Profile.
|
|
* What year was the company founded? :
|
|
|
* How many sales offices do you have? :
|
|
|
* Number of employees? :
|
|
|
* Approximate annual revenues? :
|
|
|
|
|
|
|
|
|
From which market segment does the majority of your revenue come?
|
|
|
Education
|
|
|
End User Sales
|
|
|
Government
|
|
|
Small/Medium Corporate Accounts
|
|
|
Large Corporate Accounts
|
|
|
|
|
|
|
|
Step 3: Submit.
|
* What is your primary business?
if other (please specify)
|
|
|
* Do you sell network equipment?
|
Yes
No
|
|
|
|
|
* Please list all products you currently sell
|
|
|
|
|
|
* Please list countries where you resell software or
hardware.
|
|
|
|
|
|
* How did you hear about Altima Technologies, our NetZoom
products and our reseller program?
|
|
NOTICE: By supplying my contact information, I am authorizing Altima to contact me (via E-mail, phone and/or mail) about its software products and related services, including announcements of special promotions. I understand that I will have the opportunity to opt-out of future communications at that time.
|
|
