Matrox Authorized Reseller Application

*denotes required fields

Corporate information

*Company *Telephone
*Address *E-mail
*City *Language
*Country *Website address
Postal/zip code    

Billing Address

  Billing information is the same as above address
Postal/zip code
*1. Sales contact *2. Technical support contact
Name Name
Position Position
Tel Tel
E-mail E-mail
*3. Demo contact *4. Purchasing contact
Name Name
Position Position
Tel Tel
E-mail E-mail
5. Financial contact 6. Marketing contact
Name Name
Position Position
Tel Tel
E-mail E-mail
*Number of employees
*Number of field sales people
Number of inside sales people
*Number of technical support people
*Number of demo artists
*Date of company establishment (yyyy/mm/dd)
Specify the dates of your financial year:
(i.e. April 1 - March 31)
*Number of offices/outlets
*Location of offices
*Do you have demo facilities?
Yes No

If yes, what are the sizes of the facilities?

*For which editing products do you maintain a demo system?
*Is your facility equipped to integrate and test turnkey systems?
Yes No

Forecasted revenue

  Current year Next year
Company total:

Market information

Please indicate what percentage of your business is represented by each of the following markets:

Broadcast  % Event videography  %
Consumer/hobbyist  % Government  %
Post production  % Independent film  %
Industrial/corporate  % other  %
Education  %    

Product line information

Please indicate the products that you sell.

  Manufacturer model Unit volume per month Estimated revenues
per year
Editing hardware/
Computers Apple
White Box
Video equipment Sony
Equipment rental
Training services

Thank you for your application. Please note that submitting this application does not grant you authorization.
A Matrox account representative will contact you to review the details of the program.

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