NXN Technology - Machine-to-Machine M2M Solutions - GSM/GPRS/CDMA for AMR, AVL, Vehicle Tracking

Channel Partner Application Form

		Channel Partner Application Form.doc

Thank you for your interest in the NXN Partner Program. To receive additional information, please complete the following form in its entirety, sign it and email/fax it to the address given at the bottom of the last page. Once we have processed your form, you will receive a personal login/password to access our partners’ area, update your information, order goods or receive support.

Partner Profile

*Please select the type of partnership you want to be:

VAR (Value Added Resellers) – Provide sales, installation and support

System integrators – Provide consulting and support

Distributor – Provide sales and support

OEM/ODM

Other:

*	Company Name:
	Postal Address:
*	Country:
*	Company Website:

Business Contact

*	Name: Mr. / Ms. :
	Job Function/Title:
*	Phone:
*	Fax:
*	Email:

Technical Contact

	Same as above
*	Name: Mr. / Ms. :
	Job Function/Title:
*	Phone:
*	Fax:
*	Email:

Business Information

The year your company established in:

Your firm is:

Public Private

Number of Employees:

Annual revenues in US dollar for the last fiscal year:

*

Sales Territory Coverage:
(Please explain where your product or solution sold?)

*

Target market:

Banking/stocking

Education

Fleet management

Government

Industrial automation

Internet service

Kiosk

Medical Service

Office/Building Automation

POS (Point of Sale)

Security

Telecommunication

Test & Measurement

Transportation

Other:

*

Products on which you will focus on:

Wireless Modem Family (GPRS/CDMA)

Wireless Data Transceivers Family

-GT Series for Fixed Asset M2M applications (Remote Data Monitor/Control)
-GV Series for Mobile Asset M2M applications (Fleet Management)

Complete M2M Platform with hardware/Software

GPS+GPRS/CDMA Solution for Vehicle Tracking/Fleet Management

*

Please select the way you use your marketing budget:

Tradeshow/Road show

Advertisement Media Name:

Seminar

Direct Mail

Internet Advertisement

Website Marketing

Other:

*

Please describe your primary sales activities:

Internal Sales Call

External Sales Activities (Ex: Relationship, Direct Approach…)

Catalog Sales

Government

Web Sales

Please provide a brief overview of your company's products or services:

Please describe the project or opportunity that you are working on:

In your plan, how can NXN can support you to achieve the sales target:

Additional Comments and Questions


	Please submit any additional comments or questions here:

Please email or fax this form to
Fax: +886-2-89121195
E-mail: information@nxn.com.tw
We will contact you as soon as we have processed your application.