Partner Application Request

If you are interested in becoming a partner with Intelex, please complete the form below making sure to include as much detail as possible.

Which partner are you: *

Agent or Referral Partner
International Partner
Valued Added Reseller

Service Partner
Content Referral Partner
Technology Partner

Please choose the type of partner you intend to be from the choices above.

Provide a brief description of your business.
Which of the following best describes your primary business.
Which EHSQ management systems do you currently sell?
What industries/sectors are your primary focus?
What is the average size (in revenue) of your target customer?
How many Intelex opportunities do you currently have or foresee?
How many sales representatives does your company have?
How many EHSQ management systems have you implemented?
How many customers do you have?
What is your average deal size in US Dollars (software and services combined)?

* First Name
* Last Name
* Company
Job Title
* Country
* Phone
Ext.
* Email
Please complete all required fields.
Please provide a valid business / organization email address.

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