Partnership Form

Please enter all details and submit your application via this form. All fields marked with * are compulsory

Company Name*

Title*

Company Address*

City*

State/Province*

Zip/Postal Code*

Phone*

Fax*

Email*

Company's URL: *

When was your Company founded?*

Is your company public or privately held? *

How many employees do you have?*

How large is your technical support staff?*

Please provide a brief description of your products/services*

Please list the markets/industries that you target*

Who are your main competitors?*

What markets/industries would you be interested in targeting in partnership with BCT?*

How did you hear about BCT?*

Any additional comments?*