New Vendor Request Form

Please fill out the form below.  Our Supplier Review Team will get back to you shortly.

Name *
Phone *
Website URL *
Describe Your Business *
CLEC Cable Fiber Provider Reseller Colocation Hosted Voice Managed Services Other
Business Markets (Regions, Verticals, and Company Size You Focus On)
Do You Currently Have an Indirect Partner Program? *
What Resources does Your Partner Program Supply it's Partners (Channel Managers, Engineers, etc.) *
Name of Individual in Charge of Channel Program
What Type of Compensation Structure do You Offer? *
One-Time Payment Residual Master Agent Compensation (4% higher than other agents)
Please List Any Other Master Agents You are Currently Partnered With (if any)
Will Any Company Receive a Kickback for Telarus Signing With You? *