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Channel Partner Online Application
Name *Title

Company *
Address 1*
Address 2 (if applicable)
City *State *
Postal Code *Country *
Telephone *Ext.
Email *Website
* indicates required fields
Function Contact Name Title Phone E-Mail
Primary Contact:
Engineering:
Sales:
Equipment Procurement:
Technical Support:

 
Which best describes the Primary point of contacts job function? *
If other, please describe:
Major Business: *
How long have you been in business?*
Please indicate the number of employees in your company: *
Please indicate the number of sales personnel in your organization: * Outside Sales:
 Inside Sales:
  Field Sales:
 Certified Installers:
Install Experience: HNS Direcway Business
MotoSat Installations 		HNS Direcway Residential
Other
Does your product or service specifically target the needs of a vertical market or markets? * Yes    No
What are your top three vertical markets? *
What are your business plans for broadband satellite connectivity?
What sort of Marketing Materials does your company use to advertise it's services? * Print Media
Television
Other 		Radio Media
Internet