NSi Gold and Platinum Business Partner Application
Company Info
Company Name:
*
Contact Name:
*
Phone:
*
Position:
*
eMail:
*
# Offices:
*
# Employees:
*
# Sales Personnel:
*
# Tech Resource Personnel:
*
Company Address
Street:
*
City:
*
Country:
*
US
Canada
State:
*
N/A
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Province:
*
N/A
AB
BC
MB
NB
NF
NT
NS
NU
ON
PE
QC
SK
YT
Zip Code:
*
Phone Number:
*
Fax:
*
Information
1. Which partner level are you applying for?
*
Gold
CAP
2. Are you currently or have you ever sold Notable Solution's AutoStore offerings?
*
Yes
No
3. Approximate Company 2007 Revenue?
*
<$1,000,000
$1,000,000-$2,000,000
$2,000,000-$3,000,000
$3,000,000-$5,000,000
$5,000,000-$10,000,000
>$10,000,000
4. Which of the following categories best describes your business?
*
Document Imaging Reseller
Outsource Service Bureau
Office Equipment Dealer
E-Retailer
None
Others:
5. What are the main vertical markets on which your company focuses?
*
Financial Services
Healthcare
Insurance
Manufacturing
Education
Legal
None
Others:
6. Which Document Imaging Scanner Manufacturers do you purchase?
*
Kodak
Fujitsu
Ricoh
Canon
Panasonic
Visioneer
Bowe Bell + Howell
None
Others:
7. What Document Imaging Software do you support?
*
Kofax
eCopy
Captiva
Others:
8. Which Copier / MFP Manufacturers do you purchase?
*
Canon
Konica-Minolta
Lexmark
Ricoh
Toshiba
Sharp
HP
Xerox
None
Others:
9. What Document Management Software do you support?
*
Documentum
SharePoint
IBM-CM
Lotus Notes/Domino
OnBase
None
Others: