PARTNER REGISTRATION FORM

1. Thank you for taking the first step towards becoming a Selligent partner. Please indicate the programme to which you are applying and fill in the application form.

I am interested in the following Selligent Partner Programme:


Distribution Partner
Integration partner
Consulting partner
The following fields are mandatory:

Details

First name:

Last name:

Company:

Activity sector:

E-mail:

Phone:

Sex : Male Female

Job title:

Postcode:

County:

Country:

Language:

Company profile:
Date company established:
Expected revenue for 2008:
Number of full time employees:
Number of people in CRM division:
Existing partnership (other than CRM):
CRM:
CRM Services portfolio:
Consulting /BPR
Distribution
Implementation
Post-sales support
Others:

Vertical Expertise:
Transport & Logistics
Finance & Insurance	B2B Services
Trade & Manufacturing	Others:
Complementary expertise:

Existing partnership with CRM vendors:
Analytic
Operational
Collaborative

Geographic area of CRM activities:
Please describe the reason for your application:

How did you hear about us?

Search engine	Advertising	Press
Tradeshow	Customer	Supplier
Partner

2. Click on the Send button to process your registration form

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