XChange Solution Provider 2013 - Online Application

XChange Solution Provider 2013
DRIVING BUSINESS FORWARD WITH IT: The Channel's Impact & Influence on Customer Innovation
March 10th - 12th, 2013
The Peabody
Orlando, FL

XSP attendees are sponsored to attend and receive $200 towards travel, paid accommodations at the Peabody Hotel, and meals as part of the sponsored package.

To qualify to be a sponsored attendee, the registrant must be a decision-maker within their Solution Provider organization (Title of Director or above), their organization must have minimum annual revenue of $1 Million, and be actively selling hardware, software, or service products to their customers.

Please note: Due to limited seats at the event and minimum requirements, your registration does not guarantee attendance.

Denotes required information

Company Name:

First Name:

Last Name:

Job Title:

Business Address:

City:

State:

Zip Code:

Telephone:

Extension:

Cellphone:

E-mail Address:

Company Website:

Which of the following market segments or technology categories are of primary interest to your organization: First Choice:

Second Choice:

Third Choice:

To what degree are you responsible for finding and building the vendor partnerships and alliances for your company? Total Responsibility
Major Responsibility
Partial Responsibility
Minor Responsibility
No Responsibility

Have you attended a multi-day XChange event in 2012 or 2011 (XChange Solution Provider, XChange Government Integrator, XChange Public Sector, XChange or XChange Americas (in August), XChange Tech Innovator, NexTI) Yes, I have attended before. No, this is the first time.

What percentage of your business activity comes from the following technologies. (Please note: must add up to 100%) Application Development and/or Hosting:
Big Data (storage, data management, data centers):
Private Cloud Computing:
Public Cloud Computing:
Mobility:
Security:
Telecommunication Services (traditional and VoIP/UC/Collaboration):
Other:

What percent of your total revenue is derived from selling into the following markets? (Please note: must add up to 100%) Small Market (0-99 seats):
Mid Market (100-999 seats):
Large Market (1000 or more seats):

Please tell us the percentage of your revenue is derived from the following vertical markets (Please note: must add up to 100%): Education (K-12):
Higher Education:
Federal Government:
State/Local Government:
Private Healthcare:
Public Healthcare:
Legal:
Retail:
Manufacturing:
Real Estate:
Insurance:
Financial Services:
Construction:
Transportation:
Utilities:
Hospitality/Food Services:
Telecommunications:
Public Safety:
Engineering/Scientific:
Other:

Please identify your company's primary and secondary technology offerings:

Primary Technology (Select One)	Secondary Technology (Select All That Apply)
	Application Development
	Auto ID
	Backup and Recovery
	Barcode-Printers/Scanners
	Build Custom Systems/Servers/Storage
	Business Intelligence
	Cloud Computing
	Components/Peripherals
	Consulting/Strategy/Professional Services
	Contact Center/Call Center
	Content Resource Management (CRM)
	Data Center-Hosting/Design/Cooling
	Data Protection
	Desktops/Systems
	Develop Custom Software Solutions
	Digital Signage
	Disaster Recovery/Business Continuity
	Enterprise Content Management (ECM)
	Enterprise Resource Planning (ERP)
	Hardware Lifecycle Management
	Home Automation
	Hosting/Application Hosting
	Infrastructure Design and Implementation
	Internet Services and Solutions
	IT Consulting Services
	Laptops/Tablets
	Managed Print Services
	Managed Services Provider
	Mobility
	Networking
	Network Security
	Private Cloud
	Projectors
	Small Office/Home Office Integration
	Storage
	System Integration
	RFID
	Telecommunications
	Unified Communications
	Video Surveillance
	Virtualization
	VoIP Integration Services

What are your entire firm's approximate gross annual sales? (Example: $4.5 Million)

What is the number of employees in your entire organization? (Including all divisions, branches, and subsidiaries) Less than 5
5-9
10-19
20-99
100-999
1,000-4,999
5,000-9,999
More than 10,000

What year was your company established?

What territory does your company cover?

What percent of your total revenue is derived from each of the following? Hardware Sales: %
Software Sales: %
Services/Support: %

Please identify your company's primary and secondary distribution partners.

Primary Distributor (Select One)	Secondary Distributor (Select All That Apply)
	Arrow
	ASI
	Avnet
	Catalyst/Telecom
	CDW/CDWG
	Comstor
	D&H
	Immix Group
	Ingram Micro
	Lifeboat
	Scan Source
	SED
	Synnex
	Tech Data
	Tessco
	Westcon
	Other

If Other:

How do you expect your company's gross revenue (sales) to change during the next 12 months in US Dollars?

What is the total value of Hardware, Software, and Services that you will purchase this year from distribution, manufacturers, other Solution Providers, or any other source as elements to the solutions you will deliver to your clients in US Dollars?

Do you have an iPad? Yes
No

Do you want to download the free CRN iPad app? Yes
No