Consulting Partner Application

Please read the Consulting Partner Program Requirements and Benefits before completing the application.

Fields marked with (*) are mandatory

Personal Information

Zip Code:  

General Company Information

*Date company established (dd/mm/yyyy):  
*Public or private:  
*List 10 most recent customer implementations:  
*List which customers from above are references for your company and what solution was implemented.  
*May we contact 3 of them?  
*If Yes, please provide contact information for the 3 customers.
*If No, Why not?
Do you provide pre and post-sales services around these solutions? (check all that apply)

*Territory Coverage
Please describe the geographic territory (city, state, province, country, etc.) in which you are proposing to provide implementation services on MPY products:

Business Profile

What are the total (est.) revenues for your company? (in US Dollars)

Prior Year:

*Would you be willing to sub-contract consultants to MPY ?  
*List Services by your company  
*What MPY Technologies solutions are you interested in providing services around? (check all that apply).

*Briefly describe your business objectives for partnering with MPY Technologies. Please indicate any vertical and/or domain expertise that you have. Also include your current pre-sales, implementation and post-sales capabilities.  

Key Contacts

Please include Name, Title, Phone, Fax, and Email:
Business Development/Alliance Contact
Please include Name, Title, Phone, Fax, and Email:
Primary Technical Contact
Please include Name, Title, Phone, Fax, and Email:
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