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Dealer Information / Qualification

Company Information

Company Name : *
Address 1 : *
Address 2 :
City: * State: * Zip: *
Telephone: * Fax:

Owner / Manager Information

Name: * Title: * E-mail: *
Name: Title: E-Mail:
Name: Title: E-mail:
( * required information)

General Information

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Do you have an AS/400 on site? Model:
Do You have a Mainframe on Site? Model:
Do you have a Local Area Network?    
Is your network attached to the host system(s)?    
Years in business:    
What percentage of your business is derived from the following ?
- Print Servers:    
- Display Stations:    
- Communication Equipment:    
- Software:    
- Maintenance / Service:    
- Consulting:    
- Other:    
(Please specify):    
 
Do you deal in used equipment?    
 
What means do you employ to sell products? (advertising, mail, telemarketing, etc. )
 
What manufacturers' products are you currently selling?
- Print Servers
- Display Stations
- Printers
- Wireless
- Other
       
Sales and Customer Support:
- Number of employees in Sales:    
- Number of employees in Support:    
       
Total number of employees:    
       
How do you handle customer service?
       
Geographic Coverage:
Please list states and countries you currently cover with your sales efforts)
       
In which cities of these states and countries do you have active sales coverage?
       
Market Segments:
Are there particular AS400, Mainframe, or LAN segments you currently sell to, or plan to address? (Example: Barcoding, OCR, Applications, Software, Point of Purchase, etc.)
       
Do you make sales projections? If yes, please estimate below:
Monthly Annually
Print Servers
Display Stations
Printers
Controllers
Other
(please specify)