Pacom VAR Application

Pacom Systems designs, develops and manufactures integrated and networked security solutions for a range of single and multi-site applications. Pacom distributes its solutions worldwide through carefully selected Value Added system integrators. As part of the qualification process, we require all potential Resellers to submit this form. Please note that this is not a contract, and that there is no guarantee that your company will or will not be selected - we merely evaluate the potential of a partnership between our companies. Also please rest assured that all information is held in strict confidence.

Fields tagged with a red asterisk (*) are required. The submission process will reject any forms with blank values in these fields. If you wish, you may also print this page, fill it out and mail or fax to Pacom Systems.

Company Information

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Contacts
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Business Overview

Public Company    Privately held
(including product, installation and service revenue - please include unit of currency)
(excluding installation and service revenue - please include unit of currency)

How many "new" systems has your company sold over the past 12 months?

Alarm Sites:
Access Control Systems:
CCTV Systems:
Other Types of System:   Explain:

Given your knowledge of Pacom Systems solutions, what would be your estimated forecast of new systems sales (i.e.: product purchased from Pacom Systems only) over the next:

12 months?
24 months?
36 months?

Markets Served

How many "new" systems has your company sold over the past 12 months?

Single-site installations: % *
Campus-type installations: % *
Multi-site Dialup installations: % *
Multi-site WAN installations: % *
Other: % *   Describe:

Vertical Markets

Rank your focus towards each of the following types of end-user (1 being the predominate classification)

Financial Gaming Retail
Manufacturing Transportation Hospitality
Education Healthcare Government
Other - Please specify...
Describe your geographic territory focus:

Check the Pacom Products of Interest

Sales and Products

Other security hardware and software products sold *

Please mark all that apply:

Product Name / Model Vendor Market
None

Marketing Programs

Please mark all that apply:

  Self Vendor Please Specify
Newsletter or Email Update
Tradeshows
Seminars
Direct Mail
Advertising
  Other (describe)

Technical Support Capabilities

Please mark all that apply:

  No. 8x5 24x7 Region
Telephone Support *
Advanced Replacement *
Return/Repair Service *
Software Upgrades *
Outsourced *
On-Site Support *
Other (describe)

Sales and Support Organization

List the number of people in each role:

* Inside Sales * Outside Sales
* System Engineers * Technical Support
* Marketing * Total number of employees
* Visual CAPTCHA