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General Information - Please fill in ALL Applicable Fields.
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Name of Consulting Company:
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Address Line 1:
(Number, Street, & Suite)
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City:
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State or Province:
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Zip or Mail Code:
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Country:
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Specialty Information
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Primary Linux distribution your company
supports:
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Speciality Linux distribution your company
supports:
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Consulting Specialties:
Technical Information may be placed in the scroll
box. This box is not for marketing lingo, it is
for a brief description of what you or your
company is dedicated to in the technical portion
of your consulting. For example; "We
specialize in the heterogenous network including
the connectivity of CIFS with Linux and the
Internet." (This is only an
example.)
Keywords:
Please select all that apply. You can press shift and crtl to select multiple
categories.
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Technical Information:
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Keywords:
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Company Market Information
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Reseller Hardware Authorizations:
Select all that apply:
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Linux Certifications:
Select
all that apply:
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Extra notes on company:
This can be items such as how long you have been in business, a note to potential customers or a marketing message.
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Company Contact Information
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Main Phone number: (include country & area
code)
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Support Phone: (include country and area code, N/A
is acceptable)
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Company Fax: (include country & area code)
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Contact E-mail Address: (Required)
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Support E-mail: (Please include)
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Company URL: (Do not include extra notes): |
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Primary Contact First Name:
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Primary Contact Last Name:
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Username:
Type a username to edit this consultant with in the future.
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Password:
Type a password to edit this consultant with in the future.
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Password:
Verify password.
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