NorthPoint Micro Services

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VAR Online Application Form

Thank you for your interest in becoming a NorthPoint VAR. Please complete the entire application as accurately as possible. NorthPoint will use the information you provide for evaluation purposes only. It will be held in strict confidence and will not be made available to any third parties. Upon receipt, we will send you an acknowledgement, review your application, and respond within a few business days. You may correspond in English, French, German, Japanese, or Chinese.

Company Information:
Company Name:*
Address:*

City:*
State/Province:*
Country:*
ZIP/Postal Code:*
Phone:*:
Fax:
Website URL:*
Contact information: Business Contact
First Name:*
Last Name:*
Position:
Phone:*
Ext:
Fax:
Email:*
Technical Contact
First Name:
Last Name:
Position:
Phone:
Ext:
Fax:
Email:
Additional Company Information:
Business Area:*
Total number of employees*
Number of marketing/sales staff:
Number of customers:*
Years in business:*
Annual revenue:*
Your 12 months forecast for NorthPoint sales:*
Your industry/market focus:*
Geographical Information:
Specify your company's geographical coverage:*
USA	Canada
Japan	Europe
Africa/Middle East	Asia/India
South/Latin America	Oceania/Australia
Other (please specify):
Software Expertise:
What software expertise does your company have?*

Comments/Questions/Feedback:
If you have any comments, questions or feedback for us, please provide it here:

* Required Information