Dealer Application
Company Name:
Address
Street Address
Address continued
City
State
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Alabama
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District Of Columbia
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Vermont
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Washington
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Puerto Rico
Virgin Island
Northern Mariana Islands
Guam
American Samoa
Palau
Zip
Website:
When was the company founded(year)?
Public Company
Private Company
Owner/President:
Contact Person:
Phone #:
(
)
-
Email Address:
Geographic area of operation (please use detail):
Number of Locations:
Where?
Services Provided:
Document Imaging
Microfiche Imaging
Microfilm Imaging
Large Format Scanning
Document Storage(Hardcopy)
Secure Shredding
Content Hosting (In House)
Other Services Provided:
Do you currently provide software sales?
Yes
No
What solutions do you provide?
What are the strengths of these products and/or their companies?
What are the weaknesses of these products and/or their companies?
Do they provide you a protected territory?
Do you have a sales force actively selling software solutions?
Yes
No
# Full Time Sales:
# Part Time Sales:
Number of employees who handle software installations?
Previous year's software revenue?
Previous year's software profits?
How many licenses of software do you sell in a normal sales month?
By what percent would you realistically like to see your software profits increase?
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