Channel Deal Registration

Master Agent / Distributor*

Sub Agent / Distributor*

Partner Sales Rep First Name*

Partner Sales Rep Last Name*

Partner Sales Rep Email*

Partner Sales Rep Phone*

Partner Sales Rep Headquarters*

Partner Sales Rep Headquarters (City)*

Partner Sales Rep Headquarters (State)*

To receive opportunity registration/protection under our Partner commitment, accurate prospect information needs to be provided.

Company Name*

First Name*

Last Name*

Email*

Phone*

Location of Headquarters (Country)*

Location of Headquarters (City)*

Location of Headquarters (State)

HorizonIQ Promo Code*

Product/Solution*

Description / Comments*

Channel Deal
Registration Form