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Proxim Partner Program
Proxim Partner Form
Proxim Partner Form
1.*Desired Partner Level
Wireless Partner
Gold Partner
Platinum Partner
Distributor
DMR
End Customer
Technology Partner
A&E Partner
2.*First Name
3.*Last Name
4.*How did you learn about Proxim?
James Thomas
Industry Event
News Media
Proxim Distributor
Proxim Sales Team
Proxim Website
Proxim Webinar
Email from Proxim
Axis Communications
Other
5.*Desired Username
6.*Business Email
7.*Direct Phone Number
8.*Job Title
9.*Name of your Organization
10.*Address
11.Address Line 2
12.*City
13.*Country
Afghanistan
Africa
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua & Barbuda
Antilles
Netherlands
Arabia
Saudi
Argentina
Armenia
Aruba
Asia
Australia
Austria
Azerbaijan
Bahamas
The
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean T.
British Virgin Islands
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Caribbean
the
Cayman Islands
Central African Republic
Central America
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo
Dem. Rep. of the
Cook Islands
Costa Rica
Cote D'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor (Timor-Leste)
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Europe
European Union
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Terr.
Gabon
Gambia
the
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey and Alderney
Guiana
French
Guinea
Guinea-Bissau
Guinea
Equatorial
Guyana
Haiti
Heard & McDonald Is.(AU)
Holy See (Vatican)
Honduras
Hong Kong
(China)
Hungary
Iceland
India
Indonesia
Iran
Islamic Republic of
Iraq
Ireland
Israel
Italy
Ivory Coast (Cote d'Ivoire)
Jamaica
Japan
Jersey
Jordan
Region or Country
Kazakhstan
Kenya
Kiribati
Korea Dem. People's Rep.
Korea
(South) Republic of
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democ. Rep.
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Liechtenstein
Lithuania
Luxembourg
Macao
(China)
Macedonia
TFYR
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Man
Isle of
Marshall Islands
Martinique (FR)
Mauritania
Mauritius
Mayotte (FR)
Mexico
Micronesia
Fed. States of
Middle East
Moldova
Republic of
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar (ex-Burma)
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North America
Northern Mariana Islands
Norway
Oceania
Oman
Pakistan
Palau
Palestinian Territory
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Island
Poland
Portugal
Puerto Rico
Region or Country
Qatar
Reunion (FR)
Romania
Russia (Russian Fed.)
Rwanda
Sahara
Western
Saint Barthelemy (FR)
Saint Helena (UK)
Saint Kitts and Nevis
Saint Lucia
Saint Martin (FR)
S Pierre & Miquelon (FR)
S Vincent & Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South America
S.George & S.Sandwich
Spain
Sri Lanka (ex-Ceilan)
Sudan
Suriname
Svalbard & Jan Mayen Is.
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania
United Rep. of
Thailand
Timor-Leste (East Timor)
Togo
Tokelau
Tonga
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
US Minor Outlying Isl.
Uruguay
Uzbekistan
Vanuatu
Vatican (Holy See)
Venezuela
Viet Nam
Virgin Islands
British
Virgin Islands
U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
14.*State (if US)
15.*Zip Code
16.*Main Telephone
17.Website
18.*Years in Business
19.*Number of Employees
20.*Number of Sales Reps
21.*Number of Systems Engineers
22.*Annual Revenue
23.*Markets for your wireless business
Government
Telecom/Service Provider
Healthcare
Enterprise
Education
Hospitality/Hotels/Retail
Other
24.Wifi Networking Vendors
25.Broadband Wireless Access Vendors
26.Microwave Communication Vendors
27.*Preferred Proxim Distributor
28.*Are you currently working on any projects with Proxim?
Yes
No
29.If you are currently working on projects with Proxim please explain
30.*TERMS AND CONDITIONS Terms and Conditions Partner Program Terms & Conditions: The Proxim Partner Program is in place to provide strong incentives to partners who actively promote, sell and support Proxim products and services. The Proxim Partner Program is a non-exclusive, non-transferable program available to qualifying resellers worldwide. Certain benefits and requirements vary from region to region and are specified in program literature available via download from company website or from Proxim representatives. Wherein Proxim agrees to designate Partner as a member of the Proxim Partner program, Partner agrees to follow the rules and regulations set forth regarding membership in the program. Partner understands that membership is conditioned upon adherence to rules and regulations set forth in the program documentation. Proxim reserves the right to adjust all program benefits and requirements or cancel the program at any time. ***Confidentiality*** In the normal course of business activities, Proxim will at times provide the Partner with information that is considered confidential. Such information will be marked confidential and Partner agrees to keep this information within their organization on a need to know basis and will not disclose the information or use the information for any purpose other than making business decisions and plans. Accept Terms and Conditions
Yes
No
31.Default Question
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