Ericom Deal Registration form
Partners

Ericom Deal Registration for Resellers/Partners

Registering your deal may provide you with preferred commercial terms and prevent channel conflict

Ericom respects your privacy. We will not sell your information to other companies. Please read our Privacy Policy.
Mandatory fields are marked  *

RESELLER DETAILS

Your Name  *
Reseller Name  *
Your E-mail Address  *
Your Telephone Number  *
Distributor Name (Optional)

YOUR PROSPECT'S INFORMATION

Company Name  *
Division (Optional)
# of employees in this company  *
Industry this company operates in  *
Prospect Contact Name*
Prospect Contact Job Title
Prospect Contact Email Address*
Prospect Phone Number*
Prospect Mailing Address*
Prospect Country  *
State / Province  *

OPPORTUNITY DETAILS

Solution Interest:  *
What is the customer issue / pain?  *
Product Interest  *
  Blaze
  Other

If Other, please specifiy
Are there additional products / vendors / services involved in this project? If Yes, please specify  *
When is the project due to go live?  *
Why?
Has a budget been developed and approved?  *
Have you met with the decision maker?  *
Number of expected licenses (concurrent / term license)  *
How did the customer hear about Ericom?
Please provide additional comments