ZipDX - Application

If you are a reseller of telecom equipment, we would like to work with you. Click here for more details on the ZipDX Partner Program (pdf). Please use this form to apply to the program. Fill in all the blanks and click SEND. Be sure to review our Referral Partner Agreement at the bottom of the page. We will promptly respond once we have had a chance to review your information. Thanks for your interest.

Business Name

Contact Name

Title

Address

City

State

Zip/Postal Code

Country

Telephone

Mobile

Email

Company Website

Year Established

Number of Employees

Number of Sales People

Annual Revenue (US$)

Number of Customers

Do you sell usage-based products (e.g, conferencing, ISP, hosted applications, etc.)

Provide a brief overview of your primary products and/or services

What is your primary selling method?

Consumer
Small Business (1-99 employees)
Medium Business (100-499 employees)
Enterprise (500+ employees)

What is your target market focus? (check 0 or more)

What geographical areas do you primarily serve? (check 0 or more)

Do you use teleconferencing in your own business? If yes, list provider(s)

Are you currently a Polycom reseller?

Which of the following Polycom products do you sell? (select 0 or more)

What is your projected Polycom sales volume this year?

Do you currently sell conferencing hardware? If so, describe

Do you currently sell or promote a conferencing service? If so, which?

Please provide us with any additional information regarding your interest in ZipDX

I have read and agree to the ZipDX Referral Partner Agreement