Channel Partner Application

Application Form

Please take a moment to fill out our application below, indicating your interest in becoming a PEER 1 Channel Partner. We will review your information right away and contact you shortly. Thank you for your interest in partnering with us.

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Partnership History
How did you hear about us?

Existing partnership with another hosting provider(s)?

Total customers you have resold / referred to another hosting provider(s)

Total new servers you project to resell / refer monthly

Your sales rep

Company Information
Company Name

Website

Address

City

State / Prov

Zip / Postal

Country

Primary Contact
I am a current PEER 1 customer	Yes No
If yes, your PEER 1 Account ID:

I am a current ServerBeach client	Yes No
If yes, your ServerBeach Account ID:

First Name

Last Name

Title

Phone

Email

Nature of Business
Revenue for last fiscal year

Total employees

Total customers

Industry category

Describe the services you offer

From:
To:
Message:

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Channel Partner Application

Application Form

Partnership History

Company Information

Primary Contact

Nature of Business