If you would like to become a Skipjack Affiliate or Reseller, please complete the following to help us respond with the appropriate information:
Fields marked with an * are required.
Your Name*:
Company*:
Title:
E-Mail*:
Phone*:
Website (URL):
Province/State/Country*: ---USA--- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Distict of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New England New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming ---Canada--- Alberta British Columbia Labrador Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ---International--- Asia Pacific Europe Japan Other International
Which type of relationship are you interested in?* (check all that apply)
Reseller Associate - I would like complete control over the marketing of the service and would like to share in my customers' transaction revenues.
Referral Associate - I am interested in receiving a referral award for each merchant I sign on to Skipjack Transaction Network.
Technology Alliance - I am interested in integrating Skipjack solutions with our existing software or hardware for resale to our customers.
Canadian Alliance - I am located in Canada and am interested in alliance/associate opportunities with Skipjack.
What type of business/industry are you in?
What products/services are you selling?
How did you hear about Skipjack Transaction Network? Choose One: Advertisement or Promotion Article Internet Directory Referral Search Engine Tradeshow or Conference Other
If you selected "Other", please specify:
Comments: