Linx Communications - Partners - Agents & Resellers

AGENT PROFILE APPLICATION

To become an agent for Linx' solutions, please complete this Application fully and submit it.

*First Name
*Last Name
*Company Name
*Address
*City
*State
*Zip Code
*Phone
Fax
*Email Address
*Briefly Describe your current business
Prinicpal Market Area
How, if at all, will that change in the coming 12 months?
*Profile and Number of Customers:
Current forms of Marketing?
How is your current revenue achieved? (retainer, residuals, markups, spiffs etc.?)
How do you see Linx' services fitting in with your business?
How many customers do you think you can sell these services to in the next 3 months?

Do you have a contract with another provider which precludes your signing a contract with Linx?
YES
NO