Thank you for your interest the Privacyware Partner Program.

To apply for the program, please complete the following Application (required fields bold). When your application is received, a Privacyware representative will contact you.

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First Name:

Last Name:

E-Mail:

Telephone:

Title / Company:

Address:

Address2:

City:

State/Province:

Zip Code:

Country:

< choose from list >

What Privacyware products interest you?

Company Information:

# of Employees:

Products Supported:

# of Sales Personnel:

List target regions:

How many servers are in your orgranization?

Annual Revenue (USD):

< choose from list >

Type of Customers:

.

Do you offer help desk support? Yes No

.

If yes, describe help desk processes?

.

Do you have a Mobile support workforce? Yes No

.

Do you have security professionals onsite? Yes No

.

Do you have development resources? Yes No

.

Describe training facilities:

.


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