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Apply for our partnership

* Required field

Personal Information:

First Name*

Middle Name

Last Name*

Title*

Email*

Phone*

Mobile*

Company Information:

Company Name*

Web site URL*

Address Line1*

Address Line2

City*

Zip/Postal Code*

Company Phone*

Fax*

In which cities / Countries does your company operat?

No. Of Employees*

Number of Sales Staff:*

Number of customers*

Last Year Revenue*

Date Established *

Type pf partnership*

Who referred you to Al-Elm?*

Partnership Information:

Company Description:*

Description of product/services:*

What markets do you support?*

Education

Governments

Enterprise Account (Over 5000 employee)

Corporate Account (1000 to 5000 employees)

Medium Buisness (100 to 1000 employees)

Small Buisness (Less than 100 employees)

Consumers / showrooms

Who are your major customers?*

Who are your major Technology Partners?*

HP

Oracle

Microsoft

CISCO

Red Hat

Other

Which Technical Certifications

do you have at your company?*

Microsoft Certified Professional (MCP)

Microsoft Certified System Engineer

Security Consultants

Which products are you interested to sell?*

Muqeem

Shomoos

Other

How do you plan to sell the Al-Elm products?*

How do you plan on Marketing Al-Elm to your customer base?

Are you ready to pay for upfront stock

Yes

No

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