Deal Registration

Must be first field - does not diplay on form + need to add add css script on LP

PARTNER INFORMATION

Company

First Name *

Last Name *

Email Address *

Telephone Number

Partner SE

END USER INFORMATION

Company

First Name

Last Name

Telephone Number

Email Address

Postcode

OPPORTUNITY INFORMATION

Description of Customer Problem

Location for Deployment

Would you like Exclusive Networks to install?

Yes

No

Who will be installing?

Does the End User require training?

Yes

No

Is the End User Interested in a Security Managed Service?

Yes

No

Models of Interest

Is this opportunity linked to a marketing campaign?

Yes

No

Confirm marketing campaign code

Close date

Incumbent vendor

Are you interested in subscription billing for this opportunity?

Yes

No

Next steps

2nd meeting

Eval planning

Product demo

Would you like an Eval Unit sending?

Yes

No

Please check that all fields have been completed before clicking Submit.

I agree to receive marketing related promotional materials from Exclusive Networks

I agree with the information notice & cookie policy *

address1

Got a Palo Alto Networks deal?

PARTNER INFORMATION

END USER INFORMATION

OPPORTUNITY INFORMATION

Please check that all fields have been completed before clicking Submit.