VIP Registration Form

December 8th & December 9th, 2004
The Westin Prince Hotel

Register before November 5th and WIN!!!

1st Prize - 1,000 AIR MILES® Reward Miles
2nd Prize - Signed hockey shirt (priceless)
3rd Prize - Signed hockey stick (priceless)
4th Prize - Two passes to the Post Game Celebrity Charity Event
(December 9th at the Air Canada Centre, $300 value.)

To qualify for the draw you must subscribe to eChannelLine Canada.

Immediately following the GET ConnectIT Extravaganza at Toronto's Air Canada Centre, 175 of Canada's leading VARs and System Builders gather at Toronto's Western Prince Hotel for the NetProfit Channel Retreat.

You are invited to join this elite group of VIP VARs, leading Vendors and channel editors for a day of conferences, breakout sessions and social gatherings.

Wednesday morning we get down to business … growing your business through:
  • Participation in 7 sessions with leading Vendors
  • Participation in 2 general sessions
  • Vendor booths
  • Networking with your peers and suppliers

    * First Name:
    * Last Name:
    * Company name:
    * Title:
    * Phone:
    Extension:
    * Email:
    * Address:
    * City:
    * Province/State:
    * Postal/Zip:
    Country:
    Integrated mar.com Contact:
    Comments:
    1. Would you like to attend the NetProfit Channel Retreat?
    Yes No Contact me with more info.

    2. Primary Business Category:
    VAR
    System Builder, approximate number of systems built per month:
    Internet Service Provider
    Government Buyer

    3. Which of the following solutions does your company actively provide?
    Custom hardware
    Custom software
    Business consulting/strategy/professional services
    Network/infrastructure design and implementation
    Storage
    Security
    Data protection (including: anti-virus, power, back-up, disaster recovery, business continuance)
    Wireless and mobile
    Digital convergence
    Telecommunications
    Peripherals
    Consumables
    Other:

    4. What operating systems does your company support?
    Windows
    Linux
    UNIX
    Mac O/S
    Other:

    5. What % of your revenue is from selling servers?
    % Hardware
    % Software
    % Services
    % Other:

    6. Who are your primary Distributor partners?
    Ingram Micro
    Tech Data
    Synnex
    EMJ
    Other:

    Are there any particular Distributors that you would like to meet with at the NetProfit Channel Retreat?


    7. Who are your primary Vendor partners?
    Microsoft
    Hewlett-Packard
    IBM
    Intel
    Cisco
    Sun
    DELL
    Other:

    Are there any particular Vendors that you would like to meet with at the NetProfit Channel Retreat?


    8. How many employees are there in your company (approx.):


    9. What is your annual revenue?
    Under $500K   $500K o $1M   $1M - $5M   $5M - $10M   $10M - $25M   Over $25M

    10. What % of your revenue is from:
    % Hardware
    % Software
    % Service
    % Other

    11. What % of your revenue is from:
    % Government
    % Healthcare
    % Education
    % Retail
    % Enterprise (above 2,500 seats)
    % Mid/large size businesses (1,000 - 2,499 seats)
    % Mid size businesses (500 - 999 seats)
    % Small/mid size businesses (50 - 499
    % Small businesses (5 - 49 seats)
    % SOHO/small/consumer (under 5 seats)
    % Other



    12. Do you currently receive eChannelLine Daily News?
    Yes No
    If yes: Comments:


    If no: Would you like to sign up for a complimentary subscription?
    Yes No


    Is there anyone else in your company you would like me to sign up for a complimentary subscription to eChannelLine Daily News?
    Click here to open a new browser window to sign up co-workers



    13. Do you currently receive ConnectIT?
    Yes No
    If yes: Comments:

    If no: Would you like to sign up for a complimentary subscription?
    Yes No

    Is there anyone else in your company you would like me to sign up for a complimentary subscription to ConnectIT?
    Click here to open a new browser window to sign up co-workers

    Would you like to be signed up to play in the VIP VAR hockey game at the Air Canada Centre on December 9th at 11:00.
    Yes No
    Please note: the cost for playing hockey has been waived, however, you will have to go to TicketMaster and purchase a ticket to the GET ConnectIT Extravaganza (net proceeds go to charity)

    14. If there is someone else from your organization that we should register for the NetProfit Channel Retreat?


    VIP Status typically demands:
    • Annual sales in excess of $1,000,000
    • A senior decision maker within the company who will attend the event.
    General Notes:
    • A maximum of two VARs can attend from any company.
    • VARs are responsible for their own transportation to and from the NetProfit Channel Retreat.
    • Integrated mar.com will pay all hotel accommodations, meals and entertainment for attending VARs based on two VARs per room.
    • * indicates required information.




    		•