Authorized Partner Registration Request

* indicates a required field

Partner Information

Business Name:	*
Address:	*
City:	*
State/Province:	*
Zip/Postal Code:	*
Country:	*
Phone:	*
Website:	*

Primary Contact

Mr.,Mrs.,Ms.		Mr. Mrs. Ms.
First Name	*
Last Name	*
Title	*
Phone	*
Email	*

Business Information

Years in Business	*
Number of Employees	*
Primary Market	*	Local State Country Global Choose One
Main Customer Focus	*	SOHO Small & Medium Business Enterprise Education Choose One
Product Focus	*

Submit this form to have a Nemx Reseller program manager contact you

By email: partners@nemx.com   

By Fax: (613) 831-1898       

By mail: 14 Poplarwood Avenue, Stittsville, Ontario K2S 1V3 Canada