Partner Opportunity Registration

We pride ourselves in first class customer service.

IMPORTANT: Please provide all of the information on this form  completely. All fields are required fields of entry - a registration cannot be accepted without all requested information. Once  your registration has been processed you will receive an email notification within forty-eight (48) hours of submission detailing the status. Please submit your completed form via an email attachment  to: info@coreintegrator.com

Registration Period is for six (6) months. If the end-user lead is not closed by the end of this initial registration period,  you may apply for an additional registration period of six (6) months. Partners should re-submit the original form with updated details to  info@coreintegrator.com. You will be notified by email of the status of the extension request within forty-eight (48) hours.

    Partner Information

    Date:

    Submitted by: (Partner Contact Name)

    Partner Contact Address:

    Street:

    City:

    State:

    Zip Code:

    Partner Contact Phone:

    Partner Contact Email:

    Who are you working with at CoreIntegrator?

    (If you have not been in contact with our staff - leave blank.)

    Partner Manager:

    Other:

    Prospect Information

    Prospect Company Name:

    Prospect Contact Address:

    Street:

    City:

    State:

    Zip Code:

    Prospect Contact Name:

    Prospect Contact Phone:

    Prospect Contact Email:

    Opportunity Information

    Describe the End-User Opportunity in detail (Department, Application/Use Case, Scope, Estimated Volumes, Estimated # of Users, Integrations Required, etc.)
    (Ex: AP Automation for PO and Non-PO Invoices, 1,000 inv/month, 7 people in the AP Dept, Dynamics 365 BC. Need to eliminate manual tasks and want to automate)

    Preferred timeframe for implementation:

    On-Premises or SaaS (Cloud)?

    Competition:

    Correspondence Address

    PO Box 522
    Hershey, PA 17033