Service Provider Application

North America

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Service Provider Program Application

Please complete this short application to join Motorola's Service Provider Program. The information collected and submitted on your application will not be shared outside of Motorola.
This information is used primarily for entry into the Service Provider Program, to assist Motorola in serving your needs, and to create promotions exclusively for you.

CONTACT INFORMATION

* Legal Company Name	Address 2	* Country
* First Name	* State	* Phone
* Last Name	* City	* Email
* Address 1	* Zip Code	* Web

COMPANY BACKGROUND

*1. President/CEO
Name
Phone
Email

*2. Operations Manager
Name
Phone
Email

*3. Marketing Manager
Name
Phone
Email

4. What was last year's revenue for selling Internet services?
< $999	$10,000 - $99,999	Greater than $500,000
$1,000 - $9,999	$100,000 - $499,999

*5. What percentage of your access lines are:

Wired:

Unwired:

*6. Number of years as a Service Provider?

*7. What percentage of business is to the following customers?
Residential:
Business :
Government

*8. Please specify the number of employees by category
Total number of company employees:	Number of executive management:	Number of sales personnel:
Number of technical personnel:	Number of accounting & finance personnel:	Number of administration personnel:
Number of marketing personnel:

*9. Area of coverage
	State(s) Please separate all applicable state/province abbreviations with a comma (ex. IA,MO,KS,NE)
	Zip Code(s)

*10. In the future, Motorola may develop a Service Provide locator feature hosted on Motorola's website. Would you be willing to have your company information listed?

Yes

*11. Total number of AP sites:

*12. Average APs per cluster:
Number of Motorola APs:
Number of APs from another manufacturer:
If competitive, list manufacturer(s):

*13. Are you using synchronization?

Yes

*14. Are you using Motorola network management software (Prizm / BAM)?

Yes

If not, are you using network management software from another manaufacturer?

Yes

*15. Number of Subscriber Modules:
Number of Motorola SMs:
Number of SMs from another manufacturer:
If competitive,list manufacturer(s):

*16. Type of Subscriber Modules?

2.4 GHz

5.2 GHz

5.4 GHz

5.7 GHz

900MHz

*17. Type of Backhauls/PTP currently being used (wired, licensed, unlicended):
Quantity of backhauls:
Manufacturer:

MARKETING AND SERVICES INFORMATION

*18. How do you market your business today?
Door Hangers
Billboards
TV
Publications/Newspaper
Word of Mouth
Internet
Other

*19. Are you currently using Motorola's Residential Rebate Program?
Yes
No
Other

*20. Do you provide Installation Services?
	Yes
	No
	Outsource (Explain)

*21. What other services do you provide?
Indoor Wireless LAN
VoIP
Hotspot/MESH
Powerline

Acceptance:
By submitting this application I am requesting participation in the Motorola Authorized Wireless Broadband Service Provider Program and hereby agree to: Promote the sales and service of Motorola to my target market. Abide by the guidelines set forth in the Motorola Service Provider Guidelines

The information collected and submitted on your application will not be shared outside of Motorola and is used primarily for entry into the Service Provider program.