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Credit Application

Resale Certificate


Reseller Application:

Thank you for your interest in becoming an EMD Storage Reseller. To apply, please complete the following steps:

  1. Complete the form below.

  2. Fill out the Credit Application and Resale Certificate† available on the left-hand side of this page and submit by email or fax.

  3. After your application is approved, we will contact you within 3 business days with the name and contact information of your EMD Account Manager.

Please do not hesitate to contact us with additional questions.

† This Resale Certificate is applicable only for businesses in Texas, please contact us if you are not located in Texas and we will provide you with the appropriate resale certificate for your state.

* Required field

Company Information
* Company Name:
* Address:
* City:
* State:
* Zip Code:
* Country:
* Phone :
Fax:
* E-Mail:
URL:
* Federal Tax ID Number:
Year Established:
Last Year's Revenues:
 
* Please indicate the description that most accurately describes your company:
 
 
If other:
 
* Please indicate the number of employees in your organization:
 
 

Contact Information
Primary Contact
* Name:
* Job Title:
* Phone:
* E-Mail:
Sales Contact
Name:
Job Title:
Phone:
E-Mail:
Marketing Contact
Name:
Job Title:
Phone:
E-Mail:
Accounts Payable Contact
Name:
Job Title:
Phone:
E-Mail:
 

Market Information
* Please indicate your primary target market:
 
 
Please indicate the three vertical markets that your company primarily focuses on:
(e.g. Education, Healthcare, and Manufacturing)
Primary Vertical Focus:
Second Vertical Focus:
Third
Vertical Focus:
 
* Please indicate the regions your company sells into:
North America         EMEA      APAC         Latin America         Central America/Caribbean
 
Please indicate what percentage of your revenue the following account for:
Hardware:
0-25%         25-50%         50-75%         75%+        
Software:
0-25%         25-50%         50-75%         75%+        
Services:
0-25%         25-50%         50-75%         75%+        
 
* Please indicate which storage brands you currently sell:
EMC         HP      Sun         NetApp         Apple         IBM         Compellent         LeftHand
Other
 
Please indicate the professional services you provide:
Messaging Solutions (MS Exchange, Domino, etc.)
Relational Databases (MS SQL, Oracle, etc.)
ERP (SAP, PeopleSoft, JD Edwards, etc.)
Virtualization (Virtual Iron, VMware, etc.)
Other
 

Additional Information
Please indicate which products you are most interested in:
(check all that apply)
Direct Attached Storage:
SecurStor Astra SA                   SecurStor Astra ES
Network Attached Storage:
NetStor WSS LE                     NetStor WSS R2
Storage Area Networks:
SecurStor Astra SA IP             StorTrends Series                 EqualLogic PS Series
Other
 
* Please indicate how you first learned of EMD Storage:
Received Call from EMD Sales Representative (Name):
Referral from (Company/Name):
Internet Search (Engine/Keyword):
I am a past or current customer:
Other:
 
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