Distributor Application




If you wish to be a distributor of iScan Products, fill out the fields below and press the Submit button. The information will be forwarded to iScan's Reseller staff, who will contact you after the Application has been reviewed.

General Information


Company Name:
Billing/Mailing Address: City State Zip/Postal Code
Shipping/Street Address (No P.O. Boxes): City State Zip/Postal Code
Main Telephone Number: Main Fax Number: Web Address:
President/CEO/Director Name: Title: Phone Number: E-Mail Address:
Primary Contact Name: Title: Phone Number: E-Mail Address:
Sales Contact Name: Title: Phone Number: E-Mail Address:
Technical Contact Name: Title: Phone Number: E-Mail Address:


Company Information


Years in Business: Years in DMS:
Total Annual Sales: % From DMS: # DMS Sold to Date:
# of Employees in Company: # of Salespeople: # of Salespeople for DMS:
# of Support Staff: # of Support Staff for DMS:


Coverage


Vertical Markets you Specialize In (Check all that apply):


Technical Knowledge:


What operating systems/networks do you have successful installations with
(check all that apply):

What Database Management Systems (DMS) do you have successful installations with
(check all that apply):

What other DMS products (other than iScan) are you certified/authorized to sell?
What level of certification have you obtained?

What scanners do you sell?

Please list any other hardware items that you sell.

What software products do you sell?


Other:


Briefly describe your marketing plan for DMS:




Fields in Bold are required.



Thank you for sending your Application. An iScan Representative will be in contact with you after the Application is reviewed.
VAR Application



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