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Partner Application

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Please complete this form to apply as a LiveHelpNow partner. Call (267) 888.5760 if you have any questions. Thanks.

Reseller Application

Step 1 of 3

33%

Company*
Name*
First Last
Title*
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Enter Email Confirm Email
Website*
(add https:// in front)

Years in Business*
Business Type*
- Proprietor
- Partnership
- Corporation
Distributors
Which distributors do you purchase from (click all that apply)
- Ingram Micro
- Tech Data
- D & H
- Navarre
- GE Access
- SaaSMAX
- Douglas Stewart
- Lifeboat
- Other
- None
Distribution #
Provide one distributor name and account # (used to verify reseller status)--or type NONE.
Classification
How would you classify your company? (check all that apply)
- Retailer
- VAR
- System Integrator
- Consultant
- Distributor
- OEM
- Developer
- Chain or Franchise
- Training
- Mail Order
- E-Commerce
- MSP
- Digital Agency
Verticals
Select vertical markets you concentrate and specialize in (check all that apply)
Prior Year Revenue
Projected Revenue
Anticipated revenues this year?
% Hardware*
% of your business is Hardware
% Software*
% of your business is Software
% Services*
Percentage business is Services
Geography*
What geographical area(s) do you serve (check all that apply)
- Local (50 mile)
- State Wide
- Regional (multiple states)
- National
- International
Total # Employees
# Inside Sales Employees*
# Outside Sales Employees*
# Engineers*

Relationships & Certifications
Please list primary vendors you have a formal relationship with (reseller agreements). Include key certifications.
Similar or Complimentary Products
List other products you work with that are similar or complimentary to Company products.
Value Added Services
Provide a description of your primary "Value Added" services (integration, training, custom development, consulting, etc.)
Date
Select today's date
MM slash DD slash YYYY
Reseller Agreement (please read)
Click HERE to view the Partner Agreement (opens in its own window). Please email or call the Partner Manager if you have any questions. By submitting this form, I agree to the terms of the reseller agreement.
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Comments
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Telephone

Text or Call (267) 888.5760

Email

partners@livehelpnow.com

Address

515 S West End Blvd
Suite #202
Quakertown, PA 18951

Business Hours

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Monday – Friday

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