Device Networking and Connectivity by Quatech rs232 ethernet, rs422 to ethernet, rs485 to ethernet, serial to ethernet, serial to WLAN, serial port to network, networking device, network serial bridge, serial wireless, rs232 wireless, serial 802.11, serial wifi, 802.11 to rs232, wireless serial port, serial device server, wifi modules, 802.11 module, usb to pcmcia, usb to serial adapter Connect with Reliability
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Q Partner Program Application Form

Quatech's Q-Partner Program is designed to help Resellers, VARs and Systems Integrators maximize their selling efforts and deliver reliable data connectivity products to their clients. To join the Q-Partner Program, complete and submit this application. All fields are not required, but the more information you provide the more easily we can approve your application. We guarantee to use the information you provide only for internal purposes and to never sell any information about you or your company. Please read our Privacy Statement for further information on this policy.

If you prefer to complete this form off-line, please download the .pdf version of the application and mail or fax it to Quatech.

*Starred fields are required

Contact Information
*First Name:
*Last Name:
Title:
*Company:
*Street Address:
*City:
State/Province:
 (Please use postal abbreviation)
*Zip/Postal Code:
*Country:
 
*E-Mail Address:
Company Website:
*Phone:
Fax:

Please provide any other contacts we should use for your company:

Contact Name:      E-mail:

Contact Name:       E-mail:

Company Profile
Year Established:
Approximate Revenue in most recently completed fiscal year (US$):

Over $100 million $25 to $99.99 million $10 to $24.99 million

$5 to $9.99 million $1 to $4.99 million under $1 million
Projects managed in the past 12 months:
Total number of employees in your company:

1-9   10-25   26-50   51-99   100-499   more than 500

What is your company ownership/affiliation:

Independent, single location (including website)
Independent, multiple locations (including subsidiaries)
Affiliated franchise or chain
Subsidiary of larger organization

How would you classify your business?

OEM Reseller Systems Integrator End User

Other

Select your company's main areas of expertise (use control + click to select more than 1)


Please indicate for other:

Market Profile
What percentage of your revenue is derived from each of these groups (must add to 100%)

Commercial        Government         Consumer

What percentage of your business is conducted in each of these channels (must add to 100%)

Store Location(s)      Customer Locations  

Online Sales            Phone Sales

Select the primary markets/industries to which you sell (control + click to select more than 1)

Select the primary geographic markets that you serve (control + click to select more than 1)

Select the size of the organizations your company serves (control + click to select more than 1)
Product Profile

What types of equipment do you sell or resell?

What non-Quatech manufactured serial connectivity products do you actively use and/or sell?

To what type of equipment do you typically interface (include model numbers)

Select the Operating Systems you typically support (control + click to select more than 1)

Indicate distributor(s) from which you typically buy
How long have you worked with Quatech products?

Indicate the Quatech Product Line(s) in which you are interested:

Are there any other platforms for which you require serial connectivity (now or expected?)

Where did you first hear about Quatech?


By submitting this application and by signing below, I certify that I have read and agree to the terms and conditions of the Quatech Q-Partner Program as outlined in the "Q-Partner Program Terms and Conditions" document, and that the information contained herein is true and correct. I will inform Quatech in writing should any of the information change. I understand that I may be eligible to purchase and receive Quatech products either directly or from and authorized Distributor prior to notification of Q-Partner approval. I understand that receiving Quatech products prior to Q-Partner approval does not designate my organization as a Quatech Q-Partner Program Reseller, and that final Quatech approval is required for this designation.
Check here in lieu of signature to indicate that you accept the "Q-Partner Program Terms and Conditions"
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