EnPower Partner Program
This application applies ONLY to Canada and the U.S.

alt Download EnPower Partner Program Sheet now

 
For Application to Become an EnGenius Authorized or Elite dealer only.
 
Date (*)
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Company (*)
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Contact Person (*)
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Position (*)
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Address (*)
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City (*)
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State (*)
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Zip (*)
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Billing Information:
Billing Address (if different)
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City
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State
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Zip
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Telephone (*)
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Fax
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Email Address (*)
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Website Address
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Years in Business
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Resale Number/Tax ID (*)
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Application For (*)


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Business Type (*)





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Product Type Sold (*)





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Sales Model (*)



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Advertising (*)





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Customer Segment(s) (*)














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Number of Staff (*)
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Number of Sales Staff (*)
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Number of Tech Staff (*)
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Distributors:
Distributor 1 (*)
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Distributor 1 Account # (*)
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Distributor 2 Name
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Distributor 2 Account #
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Distributor 3 Name
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Distributor 3 Account #
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Distributor 4 Name
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Distributor 4 Account #
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How Did You Hear About Us? (Distributor Name, Search Engine Name, Referral Name) (*)
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Products of Interest (*)

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Best time to reach you? (*)





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Primary Sales Contact
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Primary Technical Contact
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Attach Reseller/Tax Certificate Here
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If unable to attach certificate, please fax to (714) 432-8667, Attn: Channel Marketing
 
* Applications are not complete without submitting a Reseller/Tax Certificate
If you have questions, email partners@engeniustech.com