# Become a Referral Partner

To take advantage of all the benefits of a Zoom partnership, the first thing you need to do is register below.

Please fill in all the fields in English.

Please omit the use of special characters/symbols like ' ~ ` +

## Application Form

- **Company Legal Name**  
  *Company Legal Name Help Info*
- **Partner Display Name**  
  *Partner Display Name Help Info*
- **Local Language Display Name**  
  
- **Street**  
- **City**  
- **Postal Code**  
- **Country**  
- **Website**

Are you participating in, or do you have a relationship with, one of Zoom’s Strategic Partners?  
None selected downicon

\* Please note: As a sub-agent, you must be contracted with the Technology Services Distributor you select.

- **Referral Route**  
- **Year Founded**  
- **Total Employee Count**  
- **# of Sales Personnel**  
- **# of Sales Engineers**  
- **# Technical Support Staff**  
- **Annual Revenue (USD $)**  
- **Please list your top market segments**  
None selected downicon
- **Please tell us which collaboration services you provide today**  
None selected downicon

- **Primary Contact**  
  - First Name  
  - Last Name  
  - Designation/Title  
  - Email  
  - Phone  
  - Country  
  - Primary Contact is Due Diligence Contact  
    - Yes
    - No

- **Due Diligence/ Legal Contact**  
  - First Name  
  - Last Name  
  - Designation/Title  
  - Email  
  - Phone  
  - Country

- **Does your Company have an existing relationship with Zoom?**  
- **Is your Company a business organization or an individual person?**  
- **Is your Company (1) affiliated with a Government or Government Official, or (2) partially or wholly owned or operated by a Government or Government Official?**  
- **Will your Company or any of its employees have any interactions with or sell to Governments or Government Officials?**  
Please refer to question above for definitions.
- **Will your Company use any other service provider as part of the proposed business relationship with Zoom?**  
(Examples could include a consultant, agent etc.)
- **To your knowledge, has your Company, or any of its present or former principals, been suspended or barred from doing business, arrested, charged with any legal violation, or subject to any allegation (in the press, an investigation, or otherwise) of improper business conduct, including fraud, coercion, bribery, collusion, etc.?**  
- **Why are you planning to engage in business with Zoom?**  
Have you been in communication with any Zoom employee about a potential business relationship with Zoom?
- **Did a Zoom employee, Zoom partner, or any other person or entity recommend that you apply for this relationship?**  
For example, were you referred to Zoom by a Government Official, another Zoom employee, or Business Partner?
- **I confirm that information provided in this form is accurate to the best of my knowledge and have no reason to believe the proposed engagement will result in a violation of applicable laws or Zoom policy.**  
    - Yes

- **Submitter Name**  
- **Submitter Title or Position**  
- **Submitter Country**  
- **Submitter's Email Address**

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