Matrox Authorized Reseller Application

*denotes required fields

Corporate information

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

Billing Address

  Billing information is the same as above address
*Company
*Address
*City
*Country
Province/State
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
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?

*ENCODING_PRODUCTS_QUESTION

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  % Government  %
HOW_LABEL  % Education  %
CORPORATE_LABEL  % Post production  %
OTHER_MARKET_LABEL   other  %

Product line information

Please indicate the products that you sell.

  Manufacturer model Unit volume per month Estimated revenues
per year
STREAMING_HEADER
RECORDING_HEADER
LECTURE_HEADER

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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