Partner Sign-up Form

Partner Sign-up Form
To sign-up as a Pepwave partner, please complete the following form and provide as much information as you can. We will get back to you as soon as possible. Only serious application will be considered.

Contact Details
First Name: *
Last Name: *
Title:
Email: *
Telephone: *
Company Information
Company: *
Website:
Telephone:
Fax:
Address:
City:
Postal Code:
Country: *
State / Region:
Additional Information
Year Company Established:
No. of Offices:
Name of Countries/Regions Covered:
Average annual revenue over last 3 years: (US dollars)
Employee Information
Total No. of Employee: *
No. of Sales Representatives: *
No. of Technical Support Engineers *
No. of System/Network Engineers: *
Business Information
Business Model: Valued added reseller
System integrator
Service provider/WISP
Distributor
Consulting
OEM
Others
If Others, Please Specify:
Vertical Market Focus: Federal Government
State/Local Government
Public Safety
Education
Voice over IP
Service Provider (Telco, ISPs, etc)
Hospitality/Conference Centers
Factories and warehousing
Multi-dwelling Residential Complexes
Transportation (Airports, Train Stations, Harbors)
Mobility Solution
Automated Machinery
Others
If Others, Please Specify:
Technical Information
Technology/Solution Specialization: Internet/Data Networking
Wireless WAN/LAN
Voice over IP
Security
Load Balancing
Others
If Others, Please Specify:
Key Reference Accounts by Industry
Current Product Offerings
*Please list other major products and brands in your portfolio. How would our products fit into your portfolio?
*Based on your product portfolio, what kind of unique business solutions do you provide?
Company Experience
*Please list 3 of your biggest and/or most challenging projects in the past 12 months. Please briefly describe what were the challenges, duration of the projects, project sum and the outcome.
*Please list any current or future projects that you intend to also include our products. Please briefly describe the deployment scenario(s).
Additional Comments
Any additional comments or questions?

Thank you for taking the time to complete our channel partner data form!