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Partner Application

Title

First Name

Surname

(aka family name)

Job Title

Company Name

Address

Post/ZIP Code

Country

Telephone

Fax

Your Email Address

Web Site URL

Why do you wish to become a SmoothWall Partner?

Staff & Company Information
Total Staff	*	Sales Staff	*	Technical Staff	*
Company Founded		*

Which of the following products and services do you provide? Please tick all that apply:

Tick	Product / Service	Manufacturers, details etc.
	Firewalls
	Web Content Filtering
	Routers, Networking Hardware etc.
	Security Services/Consultancy
	Installation/On-site Support
	Help Desk (state operating hours)
	Training

Which markets do you work in? Please tick all that apply:

	Small Business (less than 50 users)		Medium Business (50 to 250 users)
	Corporate (250 to 1000 users)		Enterprise (1000+ users)

Describe your main business focus (e.g. VAR, System Integrator, Consultant etc.) and any vertical markets in which you specialise.

I would prefer to be contacted by:

Telephone

Email *

If there is any further information you would like to provide concerning your application, or if you have any questions about SmoothWall or the Partner Programme, then please enter the details below.

* = required field