|  Contact 
          Information  | 
	
	
		| First Name* | 
		
         | 
		
           *1
         | 
	
	
		| Last Name*  
         | 
		 | 
		
           *1
         | 
	
	
		| Company* | 
		 | 
		
           *1
         | 
	
	
		| Title* | 
		 | 
		
           *1
         | 
	
	
		| Address* | 
		 | 
		
           *1
         | 
	
	
		| Address2: | 
		 | 
		
         | 
	
	
		| City* | 
		
          
           | 
		
           *1
         | 
	
	
		| State/Province* | 
		
          
           | 
		
           *4
         | 
	
	
		| Country* | 
		
          
           | 
		
           *4
         | 
	
	
		| Zip/Postal Code* | 
		
          
           | 
		
           *2
         | 
	
	
		| Phone* | 
		
          
           | 
		
           *3
         | 
	
	
		| Fax:  | 
		 | 
		
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		| E-Mail Address* | 
		
          
           | 
		
           *1
         | 
	
	
		| Web Site URL:    http:// | 
		 | 
		
         | 
	
	
		
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		|  General 
          Company Information  | 
	
	
		1. 
          Company Description 
          Please provide a brief overview of your company and the services you 
          provide.*   
         | 
		
           *1
         | 
	
	
		2. 
          Target Markets  
          Please provide a brief overview of your target markets and customer base. *  
           | 
		
           *1
         | 
	
	
		| 3. 
          Company Size & Revenue | 
	
	
		| Date Established* | 
		 | 
		
           *5
         | 
	
	
		| Number of Customers Worldwide* | 
		  | 
		
           *6
         | 
	
	
		| Number of Employees Worldwide*  
         | 
		  | 
		
           *6
         | 
	
	
		| Annual Revenue*  | 
		
		
			 | 
		
          *4
         | 
	
	
		|   4. 
            Business activities 
            What are your primary business activities?* 
          
         
 
 
  
          | 
		
           *4
         | 
	
	
		5. 
          Industry Expertise 
          What is your industry expertise?*   | 
		
           *1
         | 
	
	
		6. 
          Existing software packages 
          What other software packages do you currently support?*   | 
		
           *1
       | 
	
	
		
  | 
	
	
		|   | 
	
	
		|  Value 
          Proposition  | 
	
	
		|  Why is your organization interested in 
          pursuing a partnership with Systemgroup? Please discuss how selling, 
          implementing and supporting TriForce XP will fit within 
          your organization and be a mutually beneficial arrangement. 
           
         | 
	
	
		
  | 
	
	
		|   | 
	
	
		| Country/Region | 
	
	
		Please indicate the country/region 
            for which you are requesting to become a  
            TSI Systemgroup Inc partner.  
			
          Canada 
		       
          United States 
          Latin America   
          Asia Pacific  
          Europe     | 
	
	
		
  | 
	
	
		|   | 
	
	
		|  Customer 
          References  | 
	
	
		Please identify two customer references. This information 
          will be kept confidential however,  
          TSI Systemgroup Inc. may contact these references regarding your relationship. | 
	
	
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		|  Comments 
           | 
	
	
		| Please submit any additional comments 
          here. 
           
         |