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Partner Application

Complete this form if you wish to apply to become a Shore Microsystems Technology or Channel Partner. Shore Microsystems requires completion of this application to qualify. After reviewing your company's information, the application will go before acceptance. A representative from Shore Microsystems will contact you.

An asterisk (*) indicates a required field

First Name*
Last Name*
Job Title*
Company Name*
Address 1*
Address 2
State Province or Region*
Zip or Postal Code*
Phone Number*
Fax Number*
Valid Corporate Email Address*
Please specify one of the following*:

(Systems Integrator/ Reseller/ OEM/ OTHER)