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toughbook partner programs

Panasonic TP3 Reseller Application Form


Please take a few minutes to provide us with additional information about you and your company. This brief questionnaire is intended to provide a starting point for further dialogue.
* Required Field(s)
ERROR: Please complete the missing required field(s) highlighted below.
ERROR: Please enter your first name.
First Name *
ERROR: Please enter your last name.
Last Name *
ERROR: Please enter your title.
Title *
ERROR: Please enter your business's name.
Business Name *


ERROR: Please enter your phone number.
ERROR: Please enter a valid phone number.
Business Phone *
- - ext.
ERROR: Please enter your business' address.
Business Address Line 1 *
Business Address Line 2
ERROR: Please enter your business' city.
City *
ERROR: Please enter your business' state.
State *
ERROR: Please enter your business' ZIP code.
ERROR: The ZIP code entered is invalid — Please try again.
ZIP Code *
ERROR: Please enter your email address.
ERROR: The email address you entered is not valid — Please try again.
Email Address *
ERROR: The email addresses do not match — Please try again.
Confirm Email Address *
ERROR: Please enter your Panasonic champion's name.
Panasonic Champion *
ERROR: Please enter your champion's title.
Champion Title *
ERROR: Please enter the management contact.
Management Contact *
ERROR: Please enter the management extension.
Management Extension *
ERROR: Please specify which other cities you have held operations in.
Other cities you hold
operations in *
ERROR: Please specify your annual revenue.
Annual Revenue *
ERROR: Please specify the number of employees.
Number of Employees *
ERROR: Please specify the number of sales associates.
Number of Sales Associates *
ERROR: Please specify how you learned about Panasonic Toughbook notebooks.
How did you learn about Panasonic Toughbook products? *
ERROR: Please specify which product categories you want authorization to sell.
Which product categories do you want authorization to sell? *
Fully-rugged Products - Toughbook 30, 19, 08
UltraMobile-rugged Products - Toughbook U1
ERROR: Please specify a value.
Do you currently deploy not just W/LAN, but wide-area wireless (EVDO/EDGA/HSDPA) units in your solutions? *
Yes
No
ERROR: Please specify a value.
Does your organization regularly provide vehicle-mounted solutions? *
Yes
No
ERROR: Please specify a value.
Do you currently have a relationship with any other maker of Ruggedized notebooks? *
Yes
No
ERROR: Please specify a value.
If so, whose Ruggedized solution do you sell?
ERROR: Please specify a value.
Are you willing and able to provide monthly point-of-sale reports if required? *
Yes
No
ERROR: Please specify a value.
Are you willing to appoint an employee(s) at your organization that can act as a point of contact committed to driving the Panasonic message through your organization? *
Yes
No
ERROR: Please specify a value.
Have you or your organization been authorized by Panasonic to sell Toughbook products in the past? *
Yes
No
ERROR: Please choose a range.
Roughly, what percentage of your business is developed from accounts where your organization holds a 70% or greater share of their purchases? (i.e. end-user X gives you 70% of their IT business). *
ERROR: Please specify your total annual sales.
What are your total annual notebook sales? *
What percentage of your annual sales are:
ERROR: Please enter a value.
HP *
ERROR: Please enter a value.
Acer *
ERROR: Please enter a value.
Fujitsu *
ERROR: Please enter a value.
Lenovo *
ERROR: Please enter a value.
Toshiba *
ERROR: Please enter a value.
Sony *
Please identify the primary vertical markets or services at which your company concentrates sales efforts. Select the markets that make up 75% of your business.
Transportation
Manufacturing (shop floor)
Retail/Point of Sale
Field Service Automation
Insurance/Financial Services
Designing Medical IT Solutions (hospital/clinic)
Designing or implementing Sales Force Automation projects (any industry)
Utilities (Electricity/Water)
Oil/Gas
Corporate Networking/System Integration (any industry)
Application Hosting
Telecommunications Accounts (Cable TV or Telco)
Public Safety (Police/Ambulance/Fire)
State and Local Government
Military
Various divisions of the Federal government excluding military
Academic (student/faculty or enterprise)
Sales to the consumer (via storefront or Website)
Provide security solutions to any industry (firewall, VPN, etc)
Construction
Consulting and designing solutions only. No Resale of product. (Influencer role)
Other (please specify):

Phone:

1-888-223-1012

Email:

toughbookreseller @us.panasonic.com
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