Apply for Partner Advantage Program

Centurion Representative:

Optional. Otherwise please fill in the name of Centurion represetative who introduced this program to you.

Your Company Information

Company Name: *

Other Trade Names:

Do you conduct your business or sell your products under different trade names? If yes, please indicate the trade name.

Address: *

City: *

State: *

Zip: *

Country: *

Company Phone: *

Company Fax: *

Company Website:

Contact Information

Primary Contact Person: *

Title: *

Direct Phone: *

Ext:

Email:

Alternate Contact:

Business Information

Type of Business Entity: *

State Registered or Incorporated in:

Business Model: *

General Information

Which Vertical Markets do you serve?: *

Where does your revenue come from?:

Services

Hardware

Software

Consulting

What other types of products do you carry?: *

What competing products do you carry?:

What interests you in Centurion products?:

How did you hear about Centurion?: *

What percentage of your revenue comes from storage products?: *

How much of your storage demand do you estimate will be filled with Centurion products (percentage)?:

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