New Account Survey We’d like to thank you for applying for an account with Ingram Micro, The World’s Largest IT Distributor. Office Use Only Account Number: Activation Date: To help us understand your business, please complete this short survey. 1. Please provide the below details: Company Trading Name Main Phone Number: Mobile Phone: 2. Is Reselling IT Equipment and Software your primary business function? YES If no, what is your primary market? NO 3. Tick any of the following catagories that best describe your business: System Integrator Dealer/Reseller Exporter Internet Service Provider Manufacturer Retail Internet Service Provider Software Developer/Reseller IT Consultant Wholesale Distributor Software Developer/Reseller Other: _______________________ 4. What are the main vertical markets on which your company focuses, if any (tick all that apply) Agriculture Apparel Banking Biotechnology Chemicals Communications Construction Consulting Education Electronics Energy Engineering Entertainment Environmental Financial Services Food & Beverage Government Healthcare Hospitality Insurance Machinery Manufacturing Media Not For Profit Recreation Retail Shipping Technology Telecommunications Transportation Utilities Other: ________________ 5. What type of products do you sell? Audio/Visual Cloud Computing Consumables Desktops GPS Mobile Computing Monitors Networking Notebooks OEM PC’s PDA’s POS Printers Servers Software Storage Media Switches UPS Other: ___________________ 6. How many Active customers do you currently have? 0 to 50 251 to 500 51 to 100 501 to 1000 101 to 250 1000+ 7. Are you interested in becoming a Cloud Services Reseller? YES NO 8. Please answer the below questions: a) What do you estimate you’re purchasing in total, of IT Products from all of your current distributors? $ ______________________ b) What were your Gross sales last year? $ ______________________ c) What are your Gross Sales this year to date? $ ______________________ Thank you for taking the time to complete the survey. It will help us to serve you better. Please return your completed form to [email protected] Checklist for Application Submission: ABN / ACN correctly submitted on Application Bottom of Page 1 signed by a director Pages 1 to 4 of the cash application scanned to email ([email protected]) Copy of Business Registration scanned to email([email protected]) Copy of your Company letterhead (showing your ABN) scanned to email ([email protected])