PCI AUTHORIZED RESELLER PROGRAM APPLICATION
To process this application simply fill out the following form, print it off and mail it to the address below.
PCI Official Use Only: PCI Authorized Reseller Status Approved
4) Which one of the following best describes your (primary) business? Reseller Consulting Service Provider Systems Network Integrator Software Developer Vertical Applications Reseller Original Equipment Manufacturer(OEM) Government Systems Integrator Other (please specify) 5) How long has your company been in business? Less than one year 1 to 3 years 4 to 6 years 7 to 10 years More than 10 years 6) Please provide the total number of company employees and the number of company employees who sell/support Network System Products and/or application software? Company Employees Company Employees who sell/support Network System Products. 7) Please indicate the revenue mix (totaling 100 percent) for your business (exclude parent company revenue). % Hardware % Software (purchased from vendors) % Consulting % Software (developed by your business) % Technical Support % Software development services % Training 8) What is the anticipated number of PCI Product sold per year? Asset Minder Pro Workstation Asset Minder Pro Server Asset Minder 9) Please indicate the size of company to which you primarily sell Small (1-99 Employees) Medium (100-499 Employees) F100 F500 Large (500+ Employees) F1000 10) Please indicate the number of desktops, PC Servers and minicomputers for which you have managed a solution project in the past year. Desktops: 1 to 99 100 to 499 500 to 1999 More than 2000 PC Servers : 1 to 9 10 to 49 50 to 199 More than 200 Minicomputers : 1 to 9 10 to 49 50 to 199 More than 200 11) Do you sell custom applications? YES NO If yes, please identify type of application (i.e. database, office automation, accounting) 12) What types of technical support services does your business offer? Installation Product Demonstrations Consulting Services On-site repair and Maintenance Technical Phone Support 13) If you provide training, which of the following types of training services do you offer (check all that apply)? Courses at your training facility Custom training materials per installation Video Training Customer-site training Network training On-line training materials Development/languages Other (please specify)
14) Please indicate the hardware platforms you currently sell and support (check all that apply)
Other 15) Please indicate the operating systems and networking environments you currently sell and support (check all that apply)
16) Please indicate the PCI products you plan to market. (check all that apply) Asset Minder Pro Server Asset Minder Pro Workstation Asset Minder
17) Please note your industry focus by ranking the top five client targets (number 1 receiving the highest rank)
18) Please list primary distributors from whom you currently purchase products (attach additional sheet if necessary).
To become a PCI Authorized Reseller you must satisfy the following sales and technical requirements via the options detailed below:
Please specify when and where you, or a member of your staff, have taken the required PCI Reseller Sales Authorization training course and/or PCI Technical Requirement. 1) PCI Reseller Sales Authorization Course:
2) PCI Technical Requirement:
3) Please specifiy which authorization level you are applying for: Asset Minder Dealer Asset Minder Gold Var Asset Minder Platinum Var I hereby certify that the above information is true and complete to the best of my knowledge. If approved as a PCI Authorized Reseller, I agree to abide by the attached PCI Authorized Domestic Reseller Program Terms and Conditions and the requirements of the Reseller Program Level which I am awarded. Signature:________________________________ Date:____________________________________ Name:___________________________________ Title:____________________________________ Thank you for your time in completing this application. All information will be treated confidentially. We look forward to working with you. Return to the Var Opportunities For more information on the PCI Authorized Reseller Program, contact PCI at:
12062 Valley View Street, Garden Grove, CA 92845 USA
206-1252 Lawrence Avenue East, Toronto, Ontario, M3A 1C3 Canada
Tel. (416) 690-0440, Fax (416) 694-9172 email pci-info@pci-corp.com, Web: WWW.PCI-CORP.COM
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