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StarDot Reseller Application

Contact Information

Company Name*
First Name*   Last Name*
 
Job Title*
Department
Email Address*
Please Retype E-mail Address*
Phone*
Toll-Free
Fax*
Web Site*
Address Line 1*
Address Line 2
City*
State or Province*
Zip or Postal Code*
Country*



Company Information


Year Established?*
Number of Employees*
Federal Tax ID Number*
Reseller License or Sales Permit #*
Dun & Bradstreet Number
Which industry or industries do you sell in?*
Security   IT
Construction    
Other  
At which level does your company resell?*
Installer   Dealer  
VAR   Integrator  
Distributor   Solutions Provider  
Other  
What is your annual sales revenue?*
Under $500,000   $500,000 - $2,000,000   $2,000,000 - $5,000,000
$5,000,000-$25,000,000   $25,000,000 - $200,000,000   Over $200,000,000
Have you spoken with or e-mailed
anyone at StarDot before?
  If yes, whom?
Yes   No  

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