VITAL Network Services
 
 
Channel Partner Application
 
To become a VITAL Channel Partner, please fill out the information below and select submit. Your request will be routed to the appropriate group and reviewed for synergies. Upon review, you will be contacted with more information about the program.
 
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General Company Information
Company Name:
  Address 1:
  Address 2:
  City:
  State:
  Zip Code:
  Country:
Phone:
  Fax:
Web site:
Business Information:
Number of Employees:

1-25

25-50

50-100

Over 100
Length of Time in Business:
Years Months
Primary Business:
Integrator/VAR
Distributor
Telco
What Products Do You Currently Resell?
(Check all that apply):
Routers
Switches
Access Products
VoIP
Wireless
PBXs
Network Servers
Fiber Optics
Data Storage
Other:
What Services Do You Currently Offer?
(Check all that apply):
Network Consulting/Design
Site Surveys
Staging
Installation
Project Management
Maintenance
Network Management
Other:
In What Areas Do You Provide Your Products/Services?
Locally (within a 50 mile radius of your location)
Regionally
Nationally
Internationally
What Vertical Markets Do You Currently Sell To?
(Check all that apply):
Banking/Financial Services
Communications
Education
Entertainment
Government
Healthcare
Hospitality
Insurance
Manufacturing
Retail
Transportation
Utilities
Other:
What Percentage of Your Business Comes from the Following?
Hardware:
Software:
Services:
Circuits:
Other:
Submitter Information:
Name:
Title:
Phone:
E-mail:


 

 
 
   
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