Milestone Distributor Application

Distributor Application

Company Details

Full company name *
Company reg/tax no. *
Street address *
Zip/postal code *
City *
Country *
State (if USA *)
Telephone *
Fax

Contact Details

Main contact
Firstname *
Lastname *
Email *
CEO Firstname
CEO Lastname
CEO Email
Sales VP Firstname
Sales VP Lastname
Sales VP Email
Technical Contact Firstname
Technical Contact Lastname
Technical Contact Email

Company skills

General description of core business *
Year founded *
Approximate annual revenue *
What % is service revenue? * %
What % is software revenue? * %
Number of camera solutions installed past 12 month *
Geographical coverage *
Total number of employees *
Number of employees working with security solution *
Customer segments targeted * (press ctrl to select more)
What security services does your company offer? *
Description of company's IT/Networking skills *
Description of company's CCTV skills *
Company website *
How did you hear of Milestone ? *
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