Imation InStorage Registration Form

Quality program, quality products
It's only appropriate that we've developed a program that matches the quality and versatility of our products. As always, we're committed to offering storage solutions of the highest quality to our customers.

The benefits of selling Imation data storage products are numerous:

• The #1 brand—you can never go wrong recommending the industry's #1 brand of data storage products
• Broadest product line—from the desktop to the data centre, Imation provides the right storage solutions for your customer's needs
• Highest reliability—customers trust Imation's 50 years of experience developing, manufacturing, and supporting reliable data storage products

Best of all, through the Imation InStorage Program, marketing and selling Imation storage products is easier than ever! Register for the InStorage Program today by completing the form below.

*Required fields are marked with an asterisk.

Privacy Please read Imation's Privacy Statement. Terms & Conditions Terms & Conditions of the InStorage Program are available on application by contacting the InStorage Coordinator.

Primary Contact Information
Your Primary Contact is the person resonsible for your InStorage Program membership and the distribution of the benefits your company may be eligible to receive, such as Headquarter Rebates or Market Development Funds. You also will be asked for your Sales and Marketing contact, who may or may not be the same. Supplying the right contact information helps us ensure that your company receives all relevant program information.
*Company
*First Name
*Last Name
*Job Title
*Address
*City
*Country	---------- Select One ----------- Australia New Zealand
*State	---------- Select One ----------- Australian Capital Territory New South Wales North Island Northern Territory Queensland South Australia South Island Tasmania Victoria Western Australia
*Post Code
*E-mail Address
*Telephone
*Fax
*Web Site
Sales & Marketing Contact Information
Your Sales & Marketing contact is the person at your company responsible for internal or external product promotion activities as advertising, Web marketing, or trade shows. The Sales & Marketing contact will also be responsible for redeeming any market Development Funds your company may earn.
Company
First Name
Last Name
Job Title
Address
City
Country	---------- Select One ----------- Australia New Zealand
State	---------- Select One ----------- Australian Capital Territory New South Wales North Island Northern Territory Queensland South Australia South Island Tasmania Victoria Western Australia
Post Code
E-mail Address
Telephone
Fax
Primary Business
*Your primary business is: Corporate Reseller VAR SMB System Integrator/GSI Distributor Builder/Whitebox Manufacturer Catalog/Mail Order Master Reseller VAR Consumer VAD Online Store Retail Store Other If other, please specify:
*We sell the following data storage products: Diskettes Travan Cartridges AIT DVD 8mm Consumer Hardware 4MM DAT 3480/3490/3590 CD-R/CD-RW LTO (Ultrium) SuperDisk SLR ZIP Diskettes Magnus DLT 9840/9940
*Total Data Storage Revenue: (From the selected categories above) $0 - $9,999 $100,000 - $199,999 $350,000 - $500,000 $10,000 - $49,999 $200,000 - $349,999 $500,000+ $50,000 - $99,999
*No. of Employees: 0 - 5 11 - 30 51 - 100 6 - 10 31 - 50 101 - 300
*No. of Sales Representatives: 0 - 2 6 - 12 31 - 50 3 - 5 13 - 30 51+
*No. of Technical Staff: 0 - 5 11 - 30 51 - 100 6 - 10 31 - 50 101 - 300
Target Audience/Customer Base Served
*Customer Size (No. of staff) Enterprise (1000+) SOHO (1 - 9) Corporate (500 - 999) Resellers Medium (100 - 499) Government (local/state/national) Small (10-99) Educational
Core Services Provided
*Services Provided: Installation Online IT Consulting Post-Installation Support Web Design/Hosting Network Integration Database Administration E-commerce Design and Management Selling Business Products Data Recovery
Vendor Relationships
Which of the following would be most useful for a vendor to provide to your business: (1 being most preferred, 5 being least preferred)   1 2 3 4 5 No Answer Product advice & tips Sales promotional materials Bundling of compatible materials Marketing advice and assistance News & updates Sales incentive programs Visits from representatives If other, please specify:
Buying Group
Are you a member of a Buying Group? Yes     No     No Answer Buying Group Name
Wholesaler Information
*Please indicate the wholesaler from which you would prefer to purchase Imation products. This is required to provide program rebates, measured from quarterly sales. Rebates will be accrued and paid via sales data from your nominated wholesaler only. Ingram Micro Australia ACA Pacific Dynamic Supplies Datastor New Zealand
How did you hear about the Instorage Partner Program?
*I heard about the program through a/an:	-------- Select One ------- Trade show Wholesaler Imation Sales Rep Magazine/Online Ad Direct Mail Other
If other, please specify: