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Partner Application Form
Thank you for your interest in becoming a Netgate partner. To become a partner, simply fill out the
following form and e-mail it to [email protected]. This application will help us qualify and
further understand your business so that we can better serve you and and your customers. Please
provide as much information as possible. Once submitted someone will be in contact with you
soon.
If you have any questions please e-mail us at [email protected].
Contact and Company Information
Salutation
First Name
Last Name
Job Title / Position
Company Name
Street Address
Street Address Line 2
City
State / Region
E-mail Address
Country
Phone Number
Company Web Site
Postal Code
Company Profile information
Annual Revenue (USD)
Years In Business
Total Employees
Sales Reps
Tech Engineers
Countries / Regions Serviced
Type of Reseller
Managed (Security) Service Provider
Value Added Reseller
Distributor
Retail
Other
Market Focus
Hospitality
Financial / Banking
Industrial / SCADA
Transportation
Telco Services / Virtualized Providers
Education
General SMB
Health Care
Food Services
Broadcasting
Federal Government
State / Local Government
Manufacturing
Legal
Other
How would you like to
do business with
Netgate?
pfSense firewall / system reseller
Use pfSense Trademark with your own hardware
Resell Netgate hardware
Other
What other products do you currently sell?
Additional Information: