Please fill out the form below to apply to become a reseller of Code products.

Please provide the following information:

RESELLER APPLICATION
Company Name:
Address 1:
Address 2:
City:
State or Province:
Zip or Postal Code:
Telephone Number:
Fax:
Website URL:
Where or how did you learn about Code Corporation:
CONTACT INFORMATION 
Name:
Title:
Email:
BUSINESS STRUCTURE AND BACKGROUND
Date Business Established: / / (MM/DD/YYYY)
Organization Type:

Sole Proprietorship
Partnership
Corporation
Number of Employees:
Target Sales Territory:

Local
Regional
National
International
Sales Revenue: $0 - $100K
$100K - $500K
$500K - $1M
$1M - $5M
$5M+
Revenue Breakdown: % of Revenue from System
% of Revenue from Software
% of Revenue from Components & Peripherals
% of Revenue from Service & Support
Target Market(s): Accounting
Education
Finance
Health Care
Insurance
Legal
Manufacturing
Real Estate
Sales Force Automation
Transportation
Wholesale Distribution
Other - please enter a description:
Horizontal Markets: Hardware
Networking
Internet / Intranet
RDBMS Applications
Software
Other products you sell:
Product Focus: Please list the top three products you sell:

1.

2.

3.

PROFESSIONAL SERVICES
If you have professional services, please answer the following questions:
What percentage of revenue comes from professional services? %
What types of services does your organization provide?
How many people are employed in your service organization?
CORPORATE CONTACT INFORMATION
Executive Contact:
Executive Title:
Executive Email:
Financial Contact:

Financial Title:
Financial Email:
Admin/Purchasing Contact:

Admin/Purchasing Title:
Admin/Purchasing Email:
Sales/Marketing Contact:

Sales/Marketing Title:
Sales/Marketing Email:
Service/Support Contact:

Service/Support Title:
Service/Support Email:

 

 

  

Reseller Information
 
 
 
 

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