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Thank you for choosing to become a Optoma PartnerVizion Partner. In order for us to give you the best service possible we need for you to fill out a brief company profile and let us know what channel programs best meet your suppport and business needs.
 Company Information

Company*

Mailing Address*
City*
Province*
Postal Code*
Number of years in business*
Number of Employees*
Website
 Contact Information
First Name*
Last Name*
Title
Job Function *
Phone*
  Ext.
Fax
E-mail*
Password*
 Your Business
Annual Total Sales Revenue*
Primary distributor name
Your Reseller Number
Secondary distributor name
Your Reseller Number
Please apply percentages to each of the following market segments served by your business
Staff (indicate number)
Sales    Technical   
Channel*
 Your Business License
I HEREBY CERTIFY: That I hold a valid Reseller's Permit
Reseller's Permit No.*
State*
Business of selling*
A PartnerVizion Representative will contact you to obtain a copy of your Reseller Permit.
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