Partner Application - is the % of the proposal price that is for ... Evidian Symantec Kaspersky Other McAfee Fortinet Check Point Barracuda ... Information Security Web Applications ...

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    23-Apr-2018

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    Point of contact for Partner Program

    Company Name Website

    Contact Name Email

    Job Title Telephone

    Job Function Mobile

    Address Information

    Address Zip/Postal Code

    Telephone

    Fax

    City Mobile

    Billing Information

    Contact Name Job Title

    Address

    Zip/Post code

    Telephone

    CityEmail

    Additional Contacts

    Full Name e-mail Phone

    CEO/MD

    Primary Sales

    Primary Technical

    Primary Marketing

    Other

    Partner Application

    CRYPTOCard340 March RoadSuite 600Ottawa, OntarioK2K 2E4 Canada

    Toll Free: 800-307-7042Fax: +1-613-599-2442erin.densley@cryptocard.com

    State/Province

    State/Province

  • Sources of Revenue

    Software % Service %

    Hardware % Product %

    Security Products Network Infrastructure

    Business Information

    Registered No. Year established

    No. of OfficesProject Revenue (2007)

    Reported Annual Revenue 2006 2005 2004

    2/4

    ProductsPlease indicate which of the following products you provide:

    Cisco ASA WatchGuard Firebox

    Other

    Juniper SSG/ Netscreen range Sonic Wall

    Imprivata SSO

    Check Point VPN

    How many sales per week? How many sales per month?

    Average revenue from each deal?

    What is the % of the proposal price that is for professional services?

    Average deal size in users?

    Remote Access Products

    Evidian

    Symantec Kaspersky

    Other

    McAfee Fortinet

    Check Point

    Barracuda

    BitDefender

    Security Products

  • Which areas will be your primary focus with CRYPTOCard?

    CRYPTO-Shield "Windows" CRYPTO-Shield "Apple" Hardware Tokens

    CRYPTO-Shield "Linux" CRYPTO-MAS Software Tokens

    Vertical Market Focus (select all that apply)

    Manufacturing Technology Retail

    Finance Healthcare Local Government

    Pharmaceutical Other

    Staffing Information

    Type of employee Number

    Post-Sales Technical

    Field Sales

    Marketing Internal

    Sales

    Trainer

    Pre-Sales Technical

    If you have a training centre, what is your class capacity?

    Primary Distributor:

    Additional Distributors:

    3/4

    Marketing Events / Lead Generation

    Seminars Trade Shows Webinars

    Telemarketing Direct Mail Referrals

    Email Blast Media Advertising

    Other

    Number of Marketing events: Month Quarter

  • 4/4

    Partner Acceptance

    I confirm that all information provided is true and give permission for CRYPTOCard to use the information provided for CRYPTOCard's owninternal use. I am a company Director or an Authorised signatory.

    Signature DateName

    Credit Information

    Please complete the section below if you wish to request credit terms with CRYPTOCard. Any additional supporting document, ex: auditreports, can be included with the application.

    Bank Name:

    Bank Address:

    Account #: Contact Person:

    Services Offered (Select all that apply)

    Managed Service Security Policy Development IPT

    Professional Services Vulnerability Assessments Voice/Data

    Installation & Configuration Remote Working Solutions WLAN Design

    Information Security Web Applications Network Design

    Other

    Point of contact for Partner Program

    Bill LaHam

    D:20070423000429- 04'00'

    D:20070515142724+01'00'

    1/4

    Point of contact for Partner Program

    Company Name

    Website

    Contact Name

    Email

    Job Title

    Telephone

    Job Function

    Mobile

    Address Information

    Address

    Zip/Postal Code

    Telephone

    Fax

    City

    Mobile

    Billing Information

    Contact Name

    Job Title

    Address

    Zip/Post code

    Telephone

    City

    Email

    Additional Contacts

    Full

    Name e-mail Phone

    CEO/MD

    Primary Sales

    Primary Technical

    Primary Marketing

    Other

    Partner Application

    CRYPTOCard340 March RoadSuite 600Ottawa, OntarioK2K 2E4 Canada

    Toll Free: 800-307-7042Fax: +1-613-599-2442erin.densley@cryptocard.com

    State/Province

    State/Province

    Sources of Revenue

    Software %

    Service %

    Hardware %

    Product %

    Security Products

    Network Infrastructure

    Business Information

    Registered No.

    Year established

    No. of Offices

    Project Revenue (2007)

    Reported Annual Revenue

    2006 2005 2004

    2/4

    Products

    Please indicate which of the following products you provide:

    Cisco ASA

    WatchGuard Firebox

    Other

    Juniper SSG/ Netscreen range

    Sonic Wall

    Imprivata SSO

    Check Point VPN

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    How many sales per week?

    How many sales per month?

    Average revenue from each deal?

    What is the % of the proposal price that is for professional services?

    Average deal size in users?

    Remote Access Products

    Evidian

    Yes

    0

    2

    Symantec

    Kaspersky

    Other

    McAfee

    Fortinet

    Check Point

    Barracuda

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    BitDefender

    Yes

    0

    2

    Security Products

    Which areas will be your primary focus with CRYPTOCard?

    CRYPTO-Shield "Windows"

    CRYPTO-Shield "Apple"

    Hardware Tokens

    CRYPTO-Shield "Linux"

    CRYPTO-MAS

    Software Tokens

    Vertical Market Focus (select all that apply)

    Manufacturing

    Technology

    Retail

    Finance

    Healthcare

    Local Government

    Pharmaceutical

    Other

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Staffing Information

    Type of employee

    Number

    Post-Sales Technical

    Field Sales

    Marketing Internal

    Sales

    Trainer

    Pre-Sales Technical

    If you have a training centre, what is your class capacity?

    Primary Distributor:

    Additional Distributors:

    3/4

    Marketing Events / Lead Generation

    Seminars

    Trade Shows

    Webinars

    Telemarketing

    Direct Mail

    Referrals

    Email Blast

    Media Advertising

    Other

    Number of Marketing events:

    Month Quarter

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    4/4

    Partner Acceptance

    I confirm that all information provided is true and give permission for CRYPTOCard to use the information provided for CRYPTOCard's own internal use. I am a company Director or an Authorised signatory.

    Signature

    Date

    Name

    Credit Information

    Please complete the section below if you wish to request credit terms with CRYPTOCard. Any additional supporting document, ex: audit reports, can be included with the application.

    Bank Name:

    Bank Address:

    Account #:

    Contact Person:

    Services Offered (Select all that apply)

    Managed Service

    Security Policy Development

    IPT

    Professional Services

    Vulnerability Assessments

    Voice/Data

    Installation & Configuration

    Remote Working Solutions

    WLAN Design

    Information Security

    Web Applications

    Network Design

    Other

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

    Yes

    0

    2

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