TERiX Partner / Reseller Registration
* Required
Company Name
*
Your answer
Legal Name of the Company
*
Your answer
Company Trading Name
*
Your answer
Contact Person Name
*
Your answer
Contact Person Email
*
Your answer
Contact Person Phone
*
Your answer
Company Legal Address
Address
*
Your answer
City
*
Your answer
State
*
Your answer
ZIP / Postal Code
*
Your answer
Fixed Phone Number
Your answer
FAX
Your answer
Company Physical Address (if different from Company Legal Address)
Address
Your answer
City
Your answer
State
Your answer
ZIP / Postal Cod
Your answer
Fixed Phone Number
Your answer
FAX
Your answer
Escalation Matrix Contact Details
Contact 1 Name
Your answer
Contact 1 Email
Your answer
Contact 1 Phone
Your answer
Contact 2 Name
Your answer
Contact 2 Email
Your answer
Contact 2 Phone
Your answer
Contact 3 Name
Your answer
Contact 3 Email
Your answer
Contact 3 Phone
Your answer
Company Details
Support Type
*
Comprehensive
Labour only
Parts only
Parts & Labour
Required
Company Establishment Date
*
MM
/
DD
/
YYYY
Gross Annual Sales
Your answer
Legal Structure
*
Pvt
Pvt Ltd
Proprietor
Partnership
Required
Business Licence No.
Your answer
PAN NO.
Your answer
GST NO.
Your answer
How many years in business?
Your answer
Total number of employees
*
0-50
50-100
100-150
150-200
> 200
Required
Annual revenues
Your answer
Technical Employees
0-20
20-50
50-70
70-100
> 100
Technical Type
L1
L2
L3
Other
Website URL
Your answer
SLA & Help Desk
Geographical Services Coverage Area (Direct)
Your answer
Geographical Services Coverage Area (Partner Model)
Your answer
Mention List of SLA
Your answer
Do you have your own help desk centre?
Yes
No
Clear selection
Is the helpdesk 7x24x365?
Yes
No
Clear selection
Services
Do you provide resources for FMS / Managed service
Yes
No
Clear selection
BMS Services
Yes
No
Clear selection
FMS / Manage service for One-Time activity
Yes
No
Clear selection
Countries you can provide resources for FMS / Managed service
Your answer
Engineers on Contract Basis
Yes
No
Clear selection
L1 engineers with back-up resource?
Yes
No
Clear selection
AMC for End User computing (Desktop, Laptop, Printer, Scanner, UPS)?
Yes
No
Clear selection
What SLA you can cover for EUC AMC?
Your answer
AMC for Server, Storage, Networking, Tape library?
Server
Network
Storage
Tape Library
All Device Types
Parts only for AMC support?
Yes
No
Clear selection
Stocking Location / Warehouse
Your answer
Parts Sale / Rental / Leasing / IT dispose / Depot Repair
Yes
No
Clear selection
OEM Partnership
Are you partner with any OEM?
Yes
No
Clear selection
If yes, List the OEM
Your answer
Bank Details
Partner Legal Name
Your answer
Address
Your answer
City
Your answer
Postal Code
Your answer
State
Your answer
PAN No.
Your answer
Account Holder Name (Company Account)
Your answer
Bank Name
Your answer
Bank Address
Your answer
Bank country
Your answer
Bank Branch
Your answer
Bank Key (IFSC Code)
Your answer
SWIFT Code
Your answer
Bank account number
Your answer
Authorised Signatory Details / Partner Details
First Name
Your answer
Last Name
Your answer
Job Title
Your answer
Fixed Phone Number
Your answer
Contact Email ID
Your answer
Corporate Email ID
Your answer
Cell / Mobile No
Your answer
Additional
Anything you want to add, which is not specified in the form
Your answer
Action Items
TERiX to finish technical review and business review and determine then award qualification.
This process is shorter when all information is available and answers specific questions fully. TERiX is interested in your skills and mapping our relationship completely.
Additional contacts will be provided/exchanged as action items dictate by function/business area.
Thank you once again for your participation and we look forward to understanding more about your organization and its value proposition to clients and partners.
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