Please note:  Fields marked with an asterisk * are required in order to update/complete and submit your record.
 
Company Information Contact Information Company Profile Completed by User ID/Password

 Company Information
 
* Legal Business Name:
* Billing Address:
* City:
* State:
* Zip:
* Company Telephone Number:
( )  
* Company Fax Number:
( )
* Company Website:

 Contact Information
 
Principal Sales Contact
* First Name:
* Last Name:
* Email:
* Title:
* Phone:
 ( )  Ext:
* Fax:
 ( )
Sales Manager Contact
First Name:
Last Name:
Email:
Title:
Phone: ( )  Ext:
Fax: ( )
Purchasing Agent Contact
First Name:
Last Name:
Email:
Title:
Phone: ( )  Ext:
Fax: ( )
Technical Lead Contact
First Name:
Last Name:
Email:
Title:
Phone: ( )  Ext:
Fax: ( )

 Company Profile
 
* 1.) Number of facilities / offices:  
* 2.) Total # of employee's:  
* 3.) Does your company have an outbound sales force?   Yes No
* 4.) If yes, Number of field reps:  
* 5.) Number of inside reps:  
* 6.) When was this business started?  
* 7.) Is your company an 8(a) Company?   Yes No
* 8.) If yes, when does this expire?  
* 9.) Is your company minority owned or women owned?   Yes No
* 10.) Certified by a State/Local Gov't as MBE/WBE?   Yes No
* 11.) If yes, where?  
* 12.) Does your company sell products via the internet?   Yes No
* 13.) If yes, what % of sales comes from the internet?  
* 14.) Does your company sell into the home market?   Yes No
* 15.) If yes, what % of sales comes from home sales?  
* 16.) Federal Tax ID:  
* 17.) Dun & Bradstreet #:  
* 18.) Categories of companies you sell into:(please indicate percentage for each applicable category)  
  % Commercial
  % Federal Government
  % State & Local Government, Education
 
% Total
* 19.) Of the Commercial companies you sell into:(please indicate percentage for each applicable category)  
  % Small businesses (1-100 employees)
  % Medium businesses (101-1000 employees)
  % Large businesses (1001+ employees)
 
% Total
* 20.) Approximate Annual Revenue  $
* 21.) What % of your company's TOTAL revenue is from the following?
% Hardware % Software % Service
% Total
* 22.) Company Type:
Corporation Partnership Limited Partnership Sole Proprietorship
Other 
* 23.) Would the Principal Sales Contact like to receive communications from LSI Logic via email about new products,
          promotions, etc.?   Yes No
24.) Please list the names and email addresses of additional employees (i.e. salespeople) who should receive
       these communications:
  First Name Last Name Title Email Address
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
* 25.) SPECIFIC INDUSTRIES/MARKETS SERVED (please check all that apply)
Accounting
Government  ( Local  
Public Utilities
    State   Federal )
Advertising/PR firms Hospitality(Hotel, Entertainment,    Recreation) Real Estate
Aerospace Transportation Research
Agricultural/Forestry/Fishing Insurance Retail(Auto,Service,Restaurants,etc.)
Banking/Financial/Securities Legal Services Wholesale Distribution
Commercial Manufacturing
Other (specify below)
Communication(Phone,Radio,TV,Data) Medical      
Construction Non-Profit Organizations No industry specialization
Education(
Printing/Publishing
    K-12   Higher Ed )
Engineering/Sciences
26.) For all major contracts held, please list the following (if applicable):
State Contract Name / Number PC Products on Contract
 
27.) Please list all government agencies you service or sell to (fill out if applicable):
 
* 28.) SERVICES PROVIDED BY YOUR COMPANY (please check all that apply)
Application Systems Design Help Desk Remote Processing
Configuration Services Implementation Support Software Customization
Consulting Maintenance Software Development
Data Center Design/Construction Needs Assessment Systems Analysis
Data Center Design/Implementation Network Design Systems Engineering
Design/Development Network Installation Systems Integration
Environmental Engineering Network Integration Training
Facilities Management Network Management
Other (specify below)
Financing/Leasing to End Users Project Management      
GEOGRAPHIC AREAS SERVED
29.) Please indicate all geographic areas served (describe with as much detail as necessary: cities, states, U.S. regions, international regions, etc.):
 
30.) Do you intend to export any LSI Logic products to foreign countries?   Yes No
31.) If Yes, please specify which countries.
 
* 32.) CERTIFICATIONS YOUR COMPANY CURRENTLY HAS(please check all that apply)
Access Novell Platinum Solaris
Other (specify below)
Banyan Premier NT Sun      
Lotus Notes OS/2 LAN Manager UNIX  
Microsoft SCO UNIX Visual Basic  
* 33.) CURRENT RESELLING AGREEMENTS(Please specify any reselling agreements you have with any vendor/manufacturers.)
Apple Hewlett Packard Oracle
Other (specify below)
Compaq IBM SCO UNIX      
Dell Novell SUN/Solaris  
34.) Please specify if you purchase from another source(Check all that apply)
Dealer (specify)
Distributor (specify)
Aggregator (specify)
BUSINESS FOCUS
35.) Please briefly describe your business:
 
* 36.) Please indicate the primary focus of your business:
IT (Proceed to IT Reseller Checklist)
Professional Audio Video (Proceed to Professional Audio Video Reseller Checklist)
IT Reseller Checklist: (only complete if you checked "IT" above)
37.) What networking certifications does your company have?
 
38.) What percentage of your employees are:
% Technical? % Sales?
39.) What is your geographic coverage?
Regional National Global
40.) Does your company offer Level 1 technical support to your customers?   Yes No
Professional Audio Video Reseller Checklist: (only complete if you checked "Professional Audio Video" above)
41.) Does your company specialize in Professional Audio Video solutions for business and/or home entertainment?  
      Yes No
42.) What areas (vertical applications) do you specialize in?
 
43.) What Professional Audio Video industry certifications does your company have?
 
44.) What percentage of your employees are:
% Technical? % Sales?
45.) What is your geographic coverage?
Regional National Global
46.) Which of the following services does your company offer to your customers (check all that apply)?
Site Surveys Integration and installation Consulting Custom software development
47.) Does your company offer Level 1 technical support to your customers?   Yes No

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