| Please indicate type of partnership you are interested in: |
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| Please indicate which of these products (if any) you have already evaluated: |
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| Salutation: |
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| First name: |
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| Last name: |
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| Company name: |
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| Job title: |
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| E-mail: |
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| Company address: |
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| City: |
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| State (US/Canada only): |
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| Country: |
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| Zip code: |
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| Phone: |
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| Ext: |
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| Mobile: |
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| Company website: |
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Technical contact
e-mail: |
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| Sales contact e-mail: |
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Marketing contact
e-mail: |
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What is your sales geography?
For multiple selections hold down the Crtl key
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| What is your primary business? |
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Do you resell security software and/or hardware?
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Yes
No
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| Please list all IT security products that you resell (software/hardware): |
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Do you offer Tier-1 support for the products you sell?
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Yes
No
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| How many locations do you have? |
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| How many employees in the entire organization? |
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| If you are a VAR, what distributors are you currently working with? |
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| Number of current active customers: |
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| Which category best describes your typical customer profile? |
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| What markets do you specialize in? |
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| What are your annual revenues? |
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| Please specify currency: |
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Please apply a percentage to each category based on type of revenue for your company (total must equal 100%):
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| When would you be interested in starting to work with Safend? |
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| How did you hear about Safend? |
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Would you like to subscribe to our
monthly Newsletter?
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Yes
No
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Please review the terms and conditions of the
Safend Partner Agreement |
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I agree to comply with the terms and conditions outlined in the Safend Partner Agreement.
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I will review and submit the signed agreement at a later time.
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I am completing this form as a request for additional information on Safend.
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