voipsupply

Reseller Application

*Company:
*Reseller ID:
 DBA:
*Address:
*City:
*State/Providence: *Postal Code:
*Country:
*Main Phone:  Toll Free:
 Fax #:
 Web Address:
*Sales Contact:  Title:
*Sales Email:
 Marketing Contact:  Title:
 Marketing Email:
 Tech Contact:  Title:
 Tech Email:
 
  1.Which of the following best describes your business?:
  RetailMail OrderResellerVAR
  IntegratorConsultantISPOther:
  Describe Other:
 
  2. In which ways do you advertise your products?:
  StorefrontTradeshowsDirect MailInternet
  Mail OrderCatalogSeminarsMagazines
  ReferralsNewspaperFaxE-Mail
  (Advertising)Other:
 
  3. Who makes the purchasing/procurement decisions at your company?:
 Name:    
 Title:    
 Email:    
 Phone:    
 
  4. What products do you have the most interest in?:
  ATA's Media Gateways IP Phones Soft Phones
  Video PhonesWiFi PhonesIP PBXServers
  RoutersSwitchesHeadsets 
 
  5. Where are you currently purchasing your VoIP equipment from?
  
 
  6. Do you have any interest in provisiong or fulfillment services?
  Yes No  
  If yes, would you like to receive more information about our services?
  Yes No  
 
  7. What was the amount of your equipment purchases last year?
   1-3,000 3,001-5,000 5,001-10,000 10,000-25,000
   25,001-50,000 50,001-100,000 100,000+ 
 
  8. What is your projected amount for quipment purchases this year?
   1-3,000 3,001-5,000 5,001-10,000 10,000-25,000
   25,001-50,000 50,001-100,000 100,000+ 
 
  9. Which of the following best describes your major product focus?:
  TelephonyNetworkingVoIPSoftware
  ServcieData CommunicationOther: 
  Describe Other:
 
  10. Notes/Comments: