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Channel Partner Application

Thank you for your interest in C3's Award Winning Channel Partner Program! Please tell us a little bit about yourself:

First Name(*)
Alphabetic characters only, please.

Last Name(*)
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Title
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Email Address(*)
Please enter a valid email address.

Phone Number(*)
Please enter a valid telephone number.

Preferred Contact Time(*)
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Preferred Contact Method(*)
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Please fill in your company contact information:

Company Name(*)
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Company Street Address
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Company City
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Company State
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Company Zip
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Website Address
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Please tell us a little bit about your company:

Number of Employees(*)
Numeric characters only, please.

Year Founded(*)
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Target Client Size(*)
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Current Client Base(*)
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Previous Hosting Experience(*)
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Vertical Market Expertise
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Sales Team Structure
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Preferred Marketing Activities
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Please give us some general projections on how many new clients you feel you can bring to C3 in the given periods below. Don't worry, this is just an ESTIMATE!

New Clients In First 3 Months(*)
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New Clients In First 6 Months(*)
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New Clients In First 12 Months(*)
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Based on the above projections, what partner level do you feel most comfortable applying for?

Partner Type(*)
You must choose one option.