genetec.com/partners
The Genetec channel partner program
Partner program application form
Thank you for your interest in the Genetec Channel Partner Program. It should take you approximately 15
minutes to fill out our application form. Once the form is completed, please send it to:
SalesSupport@genetec.com
.
We will review your application within one week. Please note that approval of your application is conditional. Submission
of a completed Partner Program Application is not a guarantee that your company will be approved to resell Genetec
solutions. All fields are required. If you feel a field does not apply, please indicate "N/A".
Company information
Legal company name: Date the company was founded (mm/yyyy):
Doing business as name(s) of company (if different
from legal name):
If division/subsidiary, name of parent company:
Primary contact: Number of office/branch locations:
Type of company:
USA only: MWBE
Website(s):
Primary/billing address: State/Province:
Address 2: Zip/Postal code:
City: Country:
Phone (Please include country code if not in North America):
Secondary phone:
Email: Fax:
Does your company have a demo facility? Yes No Other (If other, please explain)
Please check here if shipping and billing addresses are the same. If different, enter the shipping address below
Shipping address: State/Province:
Address 2: Zip/Postal Code:
City: Country:
Shipping address phone: (Please include country code if not in North America):
Contact information
Please provide information on key contacts within your company; if additional space is required, please use a
separate form or submit a contact list to us in an Excel spreadsheet (.xls format).
Who First name Last name Title Business phone Mobile Email
Executive(s)
Sales
Technician(s)
Project Manager(s)
Purchasing
Marketing
