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First Name *

Last Name *

Email Address *

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Lead details: ------------------------------------------------------------------------------

First Name

Last Name

Title

Company Name

State

City

Partners > Lead Registration

Latisys Lead Registration

Leads do not become Registered Leads until Latisys confirms registration of a prospect via return email. Latisys will confirm registration and the applicable Registered Lead Category within three (3) business days from receipt of submittal. Once a lead is registered, it will be assigned to a Latisys Account Executive for follow-up and closure.

To register a lead, all questions are required:

Partner Information

Partner Name :*

Partner Sales Person :*

Partner Phone :*

Partner Email :*

Lead/Opportunity Information

Company Name :*

Address :*

City :*

2-Digit State Abbreviation :*

Zip :*

Country :*

Company Size :*

Industry :*

First Name :*

Last Name :*

Title :*

Phone :*

Email :*

Area(s) of Interest :*

Partner Input: Estimated MRR :*

Partner Input: Compelling Event :*

Partner Input: Decision Timeframe :*

Partner Input: Competition :*

Install Facility Preference :*

Comments / Notes (if there is a preferred rep that you would like to work with, please specify that here):