Vendor Application Legal Company Name Website Company Address City Province Postal Code Primary Contact Contact Title Contact Email Contact Phone Company Overview Year Company Founded # of Employees Company Diversity status Business Model - select all that apply Business Model - select all that apply Sell Direct to End-Users Sell through Channel Referral-Only Model What, if any Stocking Requirements would be requested? What, if any Stocking Requirements would be requested? Stocking Non-Stocking Both Vendor's Class - Check all that apply Vendor's Class - Check all that apply Manufacturer Broker/Dealer Services Provider Manufacturers/OEM/ISV What Technology Segment describes your products/solutions? Please provide a brief description of your products/solutions My Product is SaaSified My Product is SaaSified Private Cloud Public Cloud Both N/A What is the primary reason you wish to partner with LOOPHOLD Security Distribution What is the primary reason you wish to partner with LOOPHOLD Security Distribution Channel Scale/Reach Partner Enablement Stocking and Logistics Supply Chain Management Services Integration Services Other For which regions do you wish to contract with LOOPHOLD Security Distribution? For which regions do you wish to contract with LOOPHOLD Security Distribution? South Africa Southern African Development Community (SADC) African Continent Other (Please Specify) Distribution Regions (Please specify Regions) What business segments would you like to partner with LOOPHOLD Security Distribution What business segments would you like to partner with LOOPHOLD Security Distribution Commercial Enterprise/Mid-Market Commercial SMB Public Sector (Fed) Public Sector (SLED and Regulated Industries) Cloud Retail/Consumer Services Vertical Industries Other Does your product line require authorization? Does your product line require authorization? Yes No What is your sales (USD) goal for business sold through LOOPHOLD Security Distribution in the first 12 months? Do you currently have a Channel Partner Program? Do you currently have a Channel Partner Program? Yes No Who are your target Channel Partners? Are you currently working with any Distribution Partners? Are you currently working with any Distribution Partners? Yes No How many active partners are buying currently (if applicable)? Do you have an existing business opportunity that would require you to onboard ASAP? Do you have an existing business opportunity that would require you to onboard ASAP? Yes No Are you an Alliance ISV with a Strategic Vendor? Are you an Alliance ISV with a Strategic Vendor? Yes No Who referred you or do you know anyone at LOOPHOLD Security Distribution? Please provide any additional information you would like to share about your company (optional) LOOPHOLD Security Distribution requires your contact information in order to respond to your query and contact you regarding our products and services. You may unsubscribe from these communications at any time by following the applicable links. We commit to protecting and securing your details, however for more information on our privacy policies please read https://www.loophold.com/privacy-policy/ LOOPHOLD Security Distribution requires your contact information in order to respond to your query and contact you regarding our products and services. You may unsubscribe from these communications at any time by following the applicable links. We commit to protecting and securing your details, however for more information on our privacy policies please read https://www.loophold.com/privacy-policy/ I agree Submit
