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Partner Program Application
PARTNER PROGRAM OVERVIEW
Level of partnership applying for:
*
Please Select
Referral Agent
Premier Partner
Elite Partner
COMPANY HQ LOCATION
Company Legal Name:
*
Mailing Address:
*
City:
*
Country:
*
Afghanistan
Albania
Algeria
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Keeling Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote DIvoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Estonia
Ethiopia
Faeroe Islands
Falkland Islands Malvinas
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guatemala
Guernsey CI
Guinea
Guinea Bissau
Guyana
Haiti
Heard and McDonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey CI
Jordan
Kazakhstan
Kenya
Kiribati
Korea Dem Peoples Rep of
Korea Republic of
Kuwait
Kyrgyzstan
Lao Peoples Democratic Republi
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Liechtenstein
Lithuania
Luxembourg
Macau
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mexico
Micronesia Fed States of
Moldova Republic of
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherland Antilles
Netherlands
Neutral Zone Saudi Iraq
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Panama
Panama Canal Zone
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Kitts and Nevis
Saint Lucia
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
St Helena
St Pierre and Miquelon
St Vincent and the Grenadines
Sudan
Suriname
Svalbard and Jan Mayen Islands
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania United Republic of
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
US Minor Outlying Islands
Uzbekistan
Vanuatu
Vatican City State
Venezuela
Viet Nam
Virgin Islands British
Wallis and Futuna Islands
Western Sahara
Yemen Republic of
Yugoslavia
Zaire
Zambia
Zimbabwe
State/Region:
*
Alabama
Alaska
Am Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Dist of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip:
*
Company Phone:
*
Company Fax:
Company URL:
*
(i.e. http://www.company.com)
Primary Contact Title
*
Primary Contact Name
*
Primary Contact E-mail Address:
*
Other Company Locations:
COMPANY INFORMATION
DUNS #:
Tax Exempt:
Yes
No
Brief Company Overview:
Privately Held or Public:
Privately Held
Publicly Traded
Company Annual Revenue (US Dollars):
Please Select
$100,000 - 250,000
$250,000 - 500,000
$500,000 - 1M
$1.1M - 5M
$5.1M - 10M
$10.1M - 20M
$20.1M - 30M
$30.1M - 40M
$40.1M - 50M
$50.1M +
Year Company was Established:
REFERRAL INFORMATION
Were you referred to our Partner Program?
Yes
No
Sales Staff
Number of Pre-Sales Engineers:
*
Number of Sales Staff:
*
Technical Staff
Number of Support Technicians:
*
Number of Project Managers:
*
Number of Implementation Technicians:
*
CURRENT PARTNERSHIPS
(Check all that apply)
*
None
Avaya
Cisco
Microsoft
Mitel
Nortel
Shoretel
Other
Captcha:
*
Enter the code.
Thank you for your application to the Interactive Intelligence, Inc. Partner Program. Once you submit the application you will be contacted. If you have any questions before then please contact us at
PartnerProgram@inin.com
.
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