Astea FieldCentrix® for Microsoft Dynamics™ CRM

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Contact Please note that an astrisk (*) represents a required field.
Company Name *
First Name: *
Last Name: *
Job Title: *
Mailing Address: *
City: *
State/Territory:
Postal Code: *
Country: *
World Region:	Americas Asia/Pacific Europe/Middle East/Africa
Phone: *
Fax:
Email Address: *
Company Website:
Primary Responsibilities:	Select One Call Center Consultant Customer Service Field Service Finance IS/IT Marketing Operations Sales Other
Partner Type
Classify Your Company: *	Select One Reseller/Distributor Platform/Hardware Provider Software/Solution Provider Systems Integrator or Consulting Company Other
Under the right conditions will you resell the products? * Yes No
Customers And Prospects
Please list all customer sites that are interested in Astea. (Seperate customers with commas) *
Please list any existing joint customers. (Seperate with commas) *
Has a joint prospect been identified? * Yes No
Company
Year Established: *
Number of Employees: *	Select One Less than 20 20 - 30 30 - 50 50 - 100 100 - 250 250 - 500 500 - 1,000 More than 1,000
Number of Sales Employees: Select One Less than 20 20 - 30 30 - 50 50 - 100 100 - 250 250 - 500 500 - 1,000 More than 1,000   Number of Professional Services Employees: Select One Less than 20 20 - 30 30 - 50 50 - 100 100 - 250 250 - 500 500 - 1,000 More than 1,000
Annual Revenues (in USD) : *	Select One 0 - 10 Million 10 - 25 Million 25 - 50 Million 50 - 100 Million 100 - 250 Million 250 - 500 Million 500 - 1 Billion Above 1 Billion
Please give a brief description of your company. * (300 words or less)
Competitors
List your top three competitors. (Seperate competitors with commas) *
How does your company differentiate itself from its competitors? (300 Words or Less)
Customer/Market
Number Of Installed Cusomers:
List your top 10 customers. (Seperate customers with commas) *
Vertical Market Support (List top three in order) *
1: Select One Automotive Education Financial Government Healthcare Imaging Inst./Controls IT Services Medical Device Utility/Energy Retail Media/Publishing Manufacturing Telecomm N/A
2: Select One Automotive Education Financial Government Healthcare Imaging Inst./Controls IT Services Medical Device Utility/Energy Retail Media/Publishing Manufacturing Telecomm N/A
3: Select One Automotive Education Financial Government Healthcare Imaging Inst./Controls IT Services Medical Device Utility/Energy Retail Media/Publishing Manufacturing Telecomm N/A
Horizontal Market Focus: *
Call Center SCM   CRM Other:
Geographic coverage:(List three primary areas of coverage) *
1: Select One United States Northwest - USA Southwest - USA Norther Midwest - USA Southern Midwest - USA Southeast - USA Northeast - USA Canada Mexico England Western Europe Eastern Europe Africa Middle East Japan Asia Latin America N/A
2: Select One United States Northwest - USA Southwest - USA Norther Midwest - USA Southern Midwest - USA Southeast - USA Northeast - USA Canada Mexico England Western Europe Eastern Europe Africa Middle East Japan Asia Latin America N/A
3: Select One United States Northwest - USA Southwest - USA Norther Midwest - USA Southern Midwest - USA Southeast - USA Northeast - USA Canada Mexico England Western Europe Eastern Europe Africa Middle East Japan Asia Latin America N/A
Partnership Information
List your current partners. (Seperate partners with commas) *
How would partnering with Astea help your business?
What other companies are you currently talking with regarding CRM or Service-Centric solutions? (Seperate companies with commas)

 

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