Application Form

(*) Required field

Company Profile

Company Name *

Address *

Complement

City *

Country *

State/Province *

ZIP/Postal Code *

Phone *

Fax

Website

Executive (President/CEO) *

Phone*

E-mail *

Contact Information

First Name *

Last Name *

Position *

Title *

Office Phone *

Mobile

Skype

Msn

E-mail *

Partnership Category

Please, select the preferred partnership option for the SoftExpert Partnership Category:

Finder
VAR (Value Added Reseller)
BPO (Business Process Outsourcing)
Reseller
Distributor

Select the solutions of interest for SoftExpert Partnership:

	Select all
	Business Process Management [BPM]
	Corporate Performance Management [CPM]
	Enterprise Asset Management [EAM]
	Enterprise Content Management [ECM]
	Enterprise Quality Management [EQM]
	Environment, Health and Safety Management [EHSM]
	Governance, Risk and Compliance Management [GRC]
	Human Capital Management [HCM]
	IT Service Management [ITSM]
	Manufacturing Quality Management [MQM]
	Product Lifecycle Management [PLM]
	Project and Portfolio Management [PPM]
	Enterprise Risk Management [ERM]

Brief Company Profile

Brief description of your current business *

How long has your company been constituted? *

Vertical market(s) that are your primary focus (Check all that apply) *

Aerospace and Defense	Automotive	Chemicals/Petrochemical
Communications	Education	Financial
Government	Healthcare	High Tech
Insurance	Manufacturing	Pharmaceuticals
Retail	Services	Telecom
Energy	Agribusiness	Other

List your main products and services *

List the region(s) or country(ies) for performing this service *

Number of worldwide offices?

Number of worldwide customers?

Companies with which you already have partnership arrangements:

List 3 companies as references, with which you maintain business relationships, and include the telephone number and contact name:

Financial Info

Last Year

Current Year (Forecast)

Annual Revenues (USD) *

Net Profit / Loss (USD)

Input the percentage breakdown of your sales to the following sized companies:

Small (1-49 employees)
Medium (50-299 employees)
Large (300-999 employees)
Very Large (1000+ employees)

Resources

How many full time employees do you have? *

How many of these would be allocated to SoftExpert related work? *

Will these be exclusive resources? *

How many of your available resources are well-grounded in the following fields:

Business Process Management [BPM]
Corporate Performance Management [CPM]
Enterprise Asset Management [EAM]
Enterprise Content Management [ECM]
Enterprise Quality Management [EQM]
Environment, Health and Safety Management [EHSM]
Governance, Risk and Compliance Management [GRC]
Human Capital Management [HCM]
IT Service Management [ITSM]
Manufacturing Quality Management [MQM]
Product Lifecycle Management [PLM]
Project and Portfolio Management [PPM]

Are you planning to hire new staff members as the need arises? *

If yes, please state how many are you planning for this year:

How did you hear about SoftExpert? *

By submitting this form, I certify that the information provided is true and accurate. This application form does not constitute an agreement by either party and is purely for information purpose.

Type the Code: 935e

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