Partner Application

Partner Application

Please fill out the form below to apply for Lextech Labs' partner program. Once we have received your application, we will contact you with next steps.

Questions? Contact us at partners@lextechlabs.com.

Contact Name: *

Company: *

Email: *

Phone: *

Street Address: *

Street Address line 2:

City: *

State/province: *

Postal code/ZIP: *

Country: *

What geographic region(s) do you cover?: *

What services do you provide?: *

	Yes	No
Do you provide consulting to assist with system selection?
Do you provide on-site installation services?
Do you sell camera equipment?
Do you install/configure networking equipment?
Do you provide training?

Web address: *

Company description as it should appear in the directory (up to 100 characters): *

Who are your target customers?: *

Who are the camera manufacturers that you primarily sell and install?: *

What are the Video Management Servers that you typically sell and install?: *

What is the size of your install base (number of customers) that you can resell iRa C3 into?: *

How did you hear about Lextech Labs?:

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Partner Application