Partner Advantage
Register
Build to Order Cable Request
Special Pricing Registration Form
Special Pricing Registration Form
* Required Fields
Please Correct the following Fields.
Please review the contact(s) below.
Reseller Information
*Are you a registered Belkin or Linksys Authorized Reseller?
Yes
No
* Required.
* Please note you must be an authorized reseller in order to register a deal. If you are not an existing Belkin or Linksys reseller, please register
here
.
*Please select your request type:
Bid Pricing Requirements
*Needs to be a minimum of $1,000
*Bids will expire after 3 months
*You must receive a bid number from Belkin as authorization
Deal Registration Requirements
* Required.
*Needs to be a minimum of $10,000
*Deal Registration will expire after 6 months
*You must receive a Deal Registration number from Belkin as authorization
*Advantage of Deal Registration - once a deal is registered; No one else can get the same discounted pricing for that product for the same end customer for a 6-month period
Up to 3 supporting documents may be uploaded (pdf, docx, docs, jpg, png or txt).
Upload
*Reseller Name:
* Required.
*First Name (Sales Person):
* Required.
*Last Name (Sales Person):
* Required.
*Address:
* Required.
*City:
* Required.
*Country:
United States
*State:
-- Select --
Alabama
Colorado
Illinois
Florida
Kansas
Alaska
Georgia
Idaho
Iowa
Indiana
Connecticut
Arizona
Delaware
Arkansas
Hawaii
California
Kentucky
Montana
Minnesota
Nevada
Michigan
Missouri
Nebraska
Maine
Mississippi
Maryland
Massachusetts
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oregon
Oklahoma
Pennsylvania
South Dakota
Tennessee
Rhode Island
Texas
South Carolina
Utah
Virginia
Washington
Wisconsin
Wyoming
Vermont
District of Columbia
Guam
Northern Mariana Islands
West Virginia
Louisiana
Marshal Islands
State is a required field.
*Zip Code:
Zip is a required field.
Special character are not allowed.
Primary Phone:
Primary Phone is a required field.
Extension:
*Email
Email is a required field.
Email id is invalid.
Distributor
D&H
Ingram Micro
Synnex
Tech Data
Prospect (End User) Information
*Company Name:
* Required.
Primary Contact:
Primary Contact Title:
Email:
Email id is invalid.
Address:
City:
Country
United States
State
-- Select --
Alabama
Colorado
Illinois
Florida
Kansas
Alaska
Georgia
Idaho
Iowa
Indiana
Connecticut
Arizona
Delaware
Arkansas
Hawaii
California
Kentucky
Montana
Minnesota
Nevada
Michigan
Missouri
Nebraska
Maine
Mississippi
Maryland
Massachusetts
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oregon
Oklahoma
Pennsylvania
South Dakota
Tennessee
Rhode Island
Texas
South Carolina
Utah
Virginia
Washington
Wisconsin
Wyoming
Vermont
District of Columbia
Guam
Northern Mariana Islands
West Virginia
Louisiana
Marshal Islands
State is a required field.
*Zip Code
Zip is a required field.
Special character are not allowed.
Primary Phone
Primary Phone is a required field.
Extension:
Summary of Reseller
History with Account:
Description of Environment
*Estimated Close Date (mm/dd/yyyy):
* Required.
*Est. $ Value of Configuration:
$1 - $4,999
$5,000 - $10,000
$10,001 - $15,000
$15,001 - $20,000
$20,001 +
* Required.
Description of competitive
environment in the account:
Description of solution
being proposed:
Alternate solutions being
considered by the customer:
Products to be part of registered deal
*Select the products and quantities:
Part Number
Quantity
[+] Add more rows
Additional Notes:
