Partner Program Application Please enable JavaScript in your browser to complete this form.1About You2About Your Company 3Your Application4Your Customers & Services5SubmitPlease complete the following form to apply to become an Circular Computing Authorized Reseller or Distributor. This application should take less than 10 minutes to complete.About YouTitle *TitleMrMrsMissDrApplicant Name *FirstLastJob Title *Organization Name *Email address *EmailConfirm EmailTelephone Number *MobileCompany Website / URL *NextHead Office AddressCountry *Please select your countryAfghanistanAfricaAlbaniaAlgeriaAngolaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBelarusBelgiumBelizeBeninBoliviaBosnia And HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoCambodiaCameroonCanadaChileChinaColumbiaCongoCreteCroatiaCyprusCzech RepublicDelhiDenmarkDjiboutiDominican RepublicDubaiEcuadorEgyptEl SalvadorEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGibraltaGreeceGreenlandGuadeloupeGuatemalaGuineaGuyanaHaitiHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle Of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKarachiKazakhstanKenyaKorea NorthKorea SouthKosovoKuala LumparKuwaitKyrgyzstanLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMauritaniaMauritiusMexicoMoldaviaMoldovaMongoliaMoroccoMozambiqueNamibiaNepalNetherlandsNetherlands AntillesNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinePapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaudi ArabiaSénégalSerbiaSeychellesSierra LeoneSingaporeSlovak RepublicSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSpainSri LankaSudanSwedenSwitzerlandSyriaTaiwanTanzaniaThailandTogoTrinidad And TobagoTunisiaTurkeyTurkmenistanUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVenezuelaVietnamYemenYugoslaviaZambiaZimbabweImportant: please ensure you select the correct country as this will direct your application to your country distributor.Address Line 1 *Address Line 2CityState (non USA) *US State *Select stateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict Of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingPostal / Zip CodeAbout Your CompanyLocal Currency *Revenue (USA) *Revenue for last fiscal year$1-5m$5-20m$20-50m$50-100m$101-250m$251-500m$500m+Revenue (RoW) *Revenue for last fiscal year1 - 5m5 - 20m20 - 50m50 - 100mOver 100mNumber of employees *Total number of employees1-25 employees26-50 employees51-100 employees101-250 employees251-500 employees501-1000 employees1001-2000 employees2000+ employeesNumber of employees (EMEA/RoW) *Total number of employees1-10 employees11-20 employees21-50 employees51-100 employees101-250 employees251-500 employees501-999 employees1000+ employeesAnnual Laptop Sales (USA) *How many laptops does your company sell annually?Under 1k units1 - 5k units5 - 10k units10 - 30k units30 - 50k units50 - 100k units100 - 200k unitsOver 200k unitsAnnual Laptop Sales (RoW) *How many laptops does your company sell annually?Under 500 units500 - 1k units1k - 3k units3k - 5k units5k - 10k units10k - 25k unitsOver 25k unitsSell used (USA) *Does your company sell IT hardware that is not new? (eg refurbished, used etc)Yes - OftenYes - Occasionally NoNot SureSell used? (RoW) *Does your company sell IT hardware that is not new? (eg refurbished, used etc)Yes - OftenYes - Occasionally NoConsent *I give my consent for Circular Computing to contact me for the purpose of processing my applicationNextAbout Your ApplicationApplication type *Why are you applying to become a partner?To become an Authorized ResellerTo become a Distributor / Country PartnerTo transact a 'one-off' opportunityWhich Circular Computing Partner Tier are you applying for? *Are you an authorized partner with another IT vendor?DistributorPlatinum ResellerGold ResellerSilver ResellerAuthorised ResellerOne Off OpportunityYou have selected only to transact a one-off opportunity above. This option will prevent you from joining higher partner tier levels at a later stage - are you sure? If not, select Authorized Reseller and you can join as the entry level tier with limited commitment and investment.One-Off Opportunity Registration *Your Profile With Other VendorsVendor Authorized (USA) *Are you an authorized partner with another IT vendor?DistributorResellerOtherVendor Authorized (RoW) *Are you an authorized partner with another IT vendor?DistributorResellerOtherOther: *Please select your current vendor program memberships: *DellOther IT hardware vendorHPSoftware accredited partner only LenovoNo current vendor programsOther hardware vendor *Highest Tier (USA) *What is the highest partner tier / level held within any vendor programTitaniumPremierPlatinumGoldSilverAuthorisedNot ApplicableHighest Tier (RoW) *What is the highest partner tier / level held within any vendor programTitaniumPremierPlatinumGoldSilverAuthorisedNot ApplicableIT Trader - ITAD or MARNextYour Customer BasePrimary Sector *Primary Target VerticalEducationGovernmentSmall BusinessMedium BusinessLarge CorporateNGOPrimary Sector *Primary Target VerticalEducationGovernmentSmall BusinessMedium BusinessLarge CorporateNGOSecondary Sector (USA) *Secondary Target VerticalGovernmentEducationSmall BusinessMedium BusinessLarge CorporateNGOSecondary Sector (RoW) *Secondary Target VerticalEducationGovernmentSmall BusinessMedium BusinessLarge CorporateNGOActive Accounts (USA) *How many active customer accounts do you have?1 - 100101 - 250 251 - 500501 - 1,0001,000 - 3,0003,000 - 5,000Over 5,000Active Accounts (RoW) *How many active customer accounts do you have?100 - 250251 - 500 501 - 1,0001,001 - 3,0003,001 - 5,000Over 5,000How did you hear about us?How did you hear about us? *How did you hear about us?Distributor InvitationGoogle Search Social Media - LinkedIn, Facebook etc.Direct Marketing - PostalDirect Marketing - EmailProposed by Colleague or Business partner Event Current Distributor *Distributor Account Manager *Distributor Account Mgr Email *Referred by *Your Marketing TeamMarketing staffHow many people are employed in your marketing department?None1 - 3 employees3 - 5 employees6 - 10 employees10+ employeesYour Value Added ServicesServices *Demo CenterWe recycle our customers old equipmentWe offer rental and/or leasing Managed ServicesDevice-as-a-ServiceCustomer Support/Help DeskOn-site EngineersOtherOther: *NextHow would you rate your experience during this application? *Rate 1 out of 5Rate 2 out of 5Rate 3 out of 5Rate 4 out of 5Rate 5 out of 5Comments:Your submission will be reviewed and a Partner Tier Level will be proposed based on our entry criteria. 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