CUBOT - Business Intelligence. Faster and Simpler


	Overview

	Partners

	Become A Partner

All information will be held in strict confidence and is used solely for the purpose of contact information.

(All fields marked * are mandatory)

Company Contact Information :

Company Legal Name : *

Doing Business As (DBA) :

Primary Contact (Full Name) : *

(If Applicable)

Office Mailing Address : *

City : *

State : *

Zip Code : *

Phone Number : *

Fax :

(Country Code - Area Code - Phone Number)

EMail : *

URL : *

Shipping Address (if different)

Accounting Contact :

Phone Number :

(Country Code - Area Code - Phone Number)

Purchasing Contact :

Phone Number :

(Country Code - Area Code - Phone Number)

Marketing Contact :

Phone Number :

(Country Code - Area Code - Phone Number)

Company Classification :

Years in Business : *

Business Type : *

Corporation Partnership

Sole Proprietorship

How would you classify your company? : *

Reseller	VAR	Systems Integrator	Consultant	Education

OEM	Developer	Chain	Franchise	Distributor

Mail Order	Others

List any vertical markets that you service :

Prior year annual revenue $ :

Projected revenue for this year $ :

Percentage revenue for :

Hardware Software Services

What geographic area does your organization serve? : *

Local (50 mile radius)	National

Regional (300 mile radius/up to 5 states)	International

Total number of employees Apx. number of employees that would sell and service : *

Full-time inside sales people	Outside sales people

Full-time pre-sales engineers	Post-sales engineers

Indicate below what types of marketing activities your company engages in.

Seminars

Newsletters

Trade Shows

Direct Mail

Print advertising

Other

Please list software vendors, hardware vendors, consulting firms and/or systems integrators with whom your company has a formal business relationship. Include any existing certificates (i.e. Microsoft solutions Provider Partner, Cisco certified, Novel Platinum, etc.) : *

Please list any relevant business relationships and alliances, including anyone you would partner with to solve your customer's end-to-end solution : *

Please provide a description of value-added services that your company offers (i.e. reseller of software, network integration, custom development, training, installation) :

Please provide a list of any products that you sell that might compete with CUBOT :

The statements provided in this application are accurate to the best of my knowledge. By clicking "submit" I understand and agree to the following:

Completion and submission of this application does not constitute acceptance by Robust Designs of the undersigned as a Reseller. Robust Designs reserves the right at its sole discretion to deny authorization for any reason. Failure to sign below will cause delay in application processing. All applications, approvals, and contracts must be complete before you may advertise or represent this location as a CUBOT Reseller. Note that no binding agreement is formed until Robust Designs has approved you as a Reseller. Robust Designs approval shall only be indicated by its written notification to you of acceptance.