GENESYS REGISTERED PARTNER APPLICATION FORM
Please note (*) indicates mandatory fields.
1.a) Applicant
* Salutation:
* First Name:
* Last Name:
* Job Title:
* Company:
* Address Line (1):
 Address Line (2):
 Mail Stop:
* City/Town:
* State/Province:
* Zip/Postal Code:
* Country:
* Your direct Phone #:
* E-mail:
* Company URL:
* 1.) Please provide a high level value proposition
overview of yourcompany's products or services:
* 1A.) Please check one:
 My company is vendor neutral, but may introduce Genesys occasionally
 My company actively recommends Genesys
* 2.) Please describe why you want to initiate
business partnership with Genesys:
 3.) For business partnership with Genesys Enterprise Solutions Group and GETS
 Check Here
* 4.) Which vertical industries do you specialize in
and/or focus your sales and marketing effort toward?
Check all that apply.
 Agriculture, Mining & Environment  Airline Transportation
 Automotive & Transit  Call Center & Outsourcing
 Cellular, GSM & Wireless  Chemicals Petroleum & Plastic
 Computer Hardware & High Tech  Computer Software & IT
 Construction  Consulting, Business Services
 Consumer Services  Education Services
 Electronic Equipment & Components  Employment Services
 Engineering, Accounting and Research  Finance - Banking
 Finance - Credit  Financial - Insurance
 Financial - Securities  Financial - Services
 Food & Beverage  Freight/Rail/Water Transport
 Gov't & Public Admin  Healthcare & Pharmaceutical
 Internet & eBusiness  Legal Services
 Leisure/Recreation/Entertainment/Gaming  Manufacturing Misc Consumer Goods
 Manufacturing Misc Durable Goods  Non-classifiable Other
 Not For Profit/Social Services  Not Provided
 Property & Real Estate  Publishing & Print Media
 Retail Trade  TV/Radio/Music/Film
 Telecommunications  Tourism and Lodging
 Transportation Services  Utilities - Energy/Gas/Sewage/Water
 Wholesale Trade
* 5.) Is there anything else you would like
us to know about your company?

Thank you for taking time to complete this entire form.
It would be advisable for you to take a printout of this form
for your reference. Use your browser's print function
to print a copy.

Please click on the Submit button below to submit your
application to us.

Next you should see a confirmation screen stating that
your application has been received. If you believe
that your submission did not go through, please send
an e-mail to interacts@genesyslab.com and we will
assist you.