Company:

Job Title:

First Name:

Last Name:

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Which business best describes your company: Systems Integrator Reseller Solutions Provider ISV Horizontal ISV Vertical Other

How much was your company’s total sales last year in USD? Less than 1 million Between 1 and 5 million Between 5 and 25 million Between 25 and 50 million Between 50 and 100 million Between 100 and 500 million Between 500 million and 1 billion Over 1 billion Not sure

How many total employees are at your company? Between 1 and 20 Between 21 and 100 Between 101 and 500 Between 501 and 1000 Between 1001 and 2000 Over 2000 Not sure

How many total sales people are at your company? Between 1 and 20 Between 21 and 100 Between 101 and 500 Over 500 Not sure

What CRM system do your sales people use? SalesForce.com Mircosoft CRM SalesLogix Epicor Clientele Sage Siebel SpringCRM Entellium ClickPoint SugarCRM ACT Goldmine Landslide Amdocs Info Onyx Pivitol Other Not sure

How many total businesses or consumers do your company serve? Between 1 and 100 Between 101 and 500 Between 501 and 1000 Between 1001 and 2500 Between 2501 and 10,000 Over 10,000 Not sure

How many documents or data types do your average customers electronically authenticate each month? Between 1 and 20 Between 21 and 299 Between 300 and 999 Between 1000 and 5000 Over 5000 Not sure

What partnership type are you interested in pursuing Referral Channel Partner Affiliate Channel Partner Solution Provider Integration Partner OEM/LAR Integration Partner Not sure

What geographical region does your company serve? North America Latin America Europe, Middle East, Africa Asia Pacific Japan Global Not sure

What interested you in the Surety Partner Program? Customer Requests Complete Product Vision Complimentary Services Competitive Pressure Expand Product Offering Other

What is your launch timeframe? Next month Next 3 months Next 6 months Next 12 months Not sure

How do you envision taking AbsoluteProof products or technologies to market? Integrated Solution - Technology Solution Integrated Solution - Business Process Stand Alone AbsoluteProof Product Offering Sales Referral Opportunities Not sure

What is the full name of the person who will sign our Mutual Non Discolsure Agreement (NDA)?

What is the NDA signer’s email address?

Tell us about your business so we can better understand the impact of partnering with you: