Company Information
* Company Name:
* Street Address:
* City:
* State:
-- select one --
..................US...................
Alabama
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...............Canada.................
Alberta
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...............Other.................
* Country:
-- select one --
United States
Afghanistan
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Angola
Antigua and Barbados
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Armenia
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Austria
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Chile
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Dominican Republic
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Ethiopia
Fiji
Finland
France
Gabon
Gambia
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Germany
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Liechtenstein
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Malawi
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Mali
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Mauritius
Mexico
Micronesia (Federated States of)
Monaco
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Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
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Panama
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Peru
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Poland
Portugal
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Republic of Korea
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Saint Kitts and Nevis
Saint Lucia
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Samoa
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Solomon Islands
Somalia
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Sweden
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The former Yugoslav Republic of Macedonia
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
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Uganda
Ukraine
United Arab Emirates
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United Republic of Tanzania
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Yemen
Yugoslavia
Zambia
Zimbabwe
* Zip/Postal Code:
* Corporate Phone:
* Corporate Fax:
Website:
Resale #:
Primary Contact
* First Name:
* Last Name:
* Job Title:
* Phone:
* Email Address:
Other Contacts
President/Owner
Sales Management Contact
Technical Contact
Marketing Contact
Accounting Contact
Product Interest
* Check all that apply:
iPrism
Open File Manager
UpdateEXPERT
Business Information
* Year Founded:
* # of Employees:
-- select one --
1 - 10
11 - 25
26 - 50
51 - 100
101 - 500
501 - 999
1000 or more
* # of Sales Representatives:
* # of Technical Support Representatives:
* Annual Sales:
-- select one --
Less than $1,000,000
$1,000,001 - $5,000,000
$5,000,001 - $10,000,000
$10,000,001 - $25,000,000
$25,000,001 - $50,000,000
$50,000,001 - $100,000,000
Over $100,000,000
Estimated Annual Sales
(St. Bernard Products only)
-- select one --
Less than $10,000
$10,001 - $50,000
$50,001 - $100,000
$100,001 - $250,000
$250,001 - $500,000
Over $500,000
Geographic Coverage
Check all that apply:
Size of Organizations You Sell To/Service
* Select one:
-- select one --
All
Less than 100 employees
101 - 499
500 - 999
1000 or more
Fortune 1000
Vertical Markets
* Select all that apply:
For multiple select:
PC: CTRL key + click
Mac: APPLE key + click
-- select one or more --
Accounting/Finance
Chemical/Pharmacy
Construction
Education - K-12
Education - Higher Ed
Government - Federal
Government - State
Government - Local
Health Care
Legal
Manufacturing
Military
Real Estate
Transportation
Utilities
Other
None
Value-Added Services
* Percentage of sales:
Services
Select all that apply:
For multiple select:
PC: CTRL key + click
Mac: APPLE key + click
-- select one or more --
Technical Support - 24/7
Technical Support - Other
Network Integrator
End User Training
Internet Security
Software Development
Web Site Development
Web Hosting
Corporate Integrator/Reseller
Consulting
Other
None
Vendor Products Supported
Select all that apply:
For multiple select:
PC: CTRL key + click
Mac: APPLE key + click
-- select one or more --
Cisco
Compaq
Computer Associates
Hewlett-Packard
IBM
Legato
Microsoft
Nortel
Novell
Oracle
Secure Computing
Sun Microsystems
SurfControl
Tivoli
Veritas
Websense
8e6
None
Technical Certifications
Select all that apply:
For multiple select:
PC: CTRL key + click
Mac: APPLE key + click
-- select one or more --
Microsoft MCSE
Cisco CCIP
Cisco CCSP
Cisco CCNP
Cisco CCDP
Cisco CCDA
Cisco CCNA
Novell CNA
Novell CNE
Novell CNI
None
Other
Please describe other:
Distributors You Prefer To Purchase Through
* Check all that apply:
Questions or Comments: