North America PowerShift Application

North America PowerShift Application. For information on the PowerShift Partner Program outside North America please visit the website for your region. Please note that the PowerShift Partner Program is not available in all countries.

Contact Info

Reseller Business Name *
Doing Business as
Job Function
Salutation
First Name *
Last Name *
Email *
Confirm Email *
Phone *
Mobile
Website
Address *
City *
State/Province
Zip/Postal Code *
Country *

Your Target Market Size

Your Target Customer Size
What size organization does your company sell to or service? (select all that apply, hold the CTRL key to select multiple items)
When selecting, please consider the total number of employees, not just those employed at the location you are servicing

Your Business Activities/Technologies

Technology Focus
Which of the following business activities is your company involved in? (select all that apply, hold the CTRL key to select multiple items)
Which technology is of greatest importance to you?

Your Sourcing

Your Netgear Distribution Suppliers
From which of the following DISTRIBUTORS do you purchase Netgear Products? (select all that apply)
Distributor Account # Distributor Representatives
A.S.I.
D & H Distributing Inc.
Ingram Micro
Jenne
Synnex
Tech Data
None/Other
Your Brands Carried
Which of the following MANUFACTURER'S BRANDS do you currently purchase? (select all that apply, hold the CTRL key to select multiple items)
How Did You Find Out About our Powershift Program?
Name of Partner Who Referred You:

Authorization

Yes I Accept

I hereby certify that I have the authority to commit my company's resources to execute the NETGEAR Powershift Partner Program Registration Agreement. I hereby release NETGEAR, Inc. from any and all liabilities associated with the program.

I acknowledge and consent to NETGEAR and its affiliates and partners contacting me from time to time to, among other things, inform me about products, services, programs and partner opportunities, provide a product or service, or measure interest in various products and service offerings. I understand that such contacts will abide by NETGEAR's privacy policy, located at http://www.netgear.com/About/PrivacyPolicy/