Partner Programs » Partner Application
Partner Application
Submit Your Partner Opportunity Now
Thank you for applying to the NTT America Partner Program. After receiving your application, a Partner Channel Manager will contact you to discuss the program in more detail.
Required fields indicated by *
Contact Information
How did you hear about the Partner Program?*
Email Announcement
Trade Publication
Web Banner Ad
Channel Partners
Phone Call from NTT America
NTT America Website
Other (specify):
I am interested in becoming a*
Referral Partner
Reseller Partner
If a Referral Partner, which type of leads will you submit?

Select all that apply
Enterprise Hosting

  • Dedicated Hosting
  • Colocation
  • Managed Security
  • Managed Storage & Recovery
  • Content Delivery
  • Hosted Exchange & Messaging
  • Enterprise Monitoring & Maintenance

Managed Private Networks

  • MPLS IP VPN
  • Private Line
  • Global Ethernet
  • ATM
Company Name *
URL*
Address*
 
City*
State*
Zip*
Phone*
(e.g., 123-456-7890)
Fax
(e.g., 123-456-7890)
Primary Contact*
Title*
Phone*
(e.g., 123-456-7890)
Email*
Secondary Contact
Title
Phone
(e.g., 123-456-7890)
Email
Are you currently enrolled in the NTT America Partner Program?*
No
Yes (Please provide your Partner ID)

Are you or any member of your family an NTT America employee?*
Company Information
Year Company Founded
Number of Employees
1 - 5
6 - 30
31 - 100
101 - 500
500+
Gross Annual Revenue Last Year ($ US)*
Projected Gross Annual Revenue This Year ($ US)*
Customer Base
Small-Medium Business
%
Retail
%
Corporate
%
Government
%
Education
%
Other
%


Please Specify:
Average number of new customers added each month
Number of Customers
Under 100
100-499
500+
Business Model
Which description best characterizes your business?*
Systems Integrator
Web Developer
Marketing Agency
ISP
ASP
CLEC
Reseller
Systems/Software/Internet Consultant
Government Reseller
Carrier
Other (specify):
What geographic territory does your company market and service?*
Target Market(s)*
Select all that apply
Consumer
Fortune 1000
Small and Medium Enterprises
Global
Domestic US Only
Vertical Markets or Market Specialization (specify)
Financial Services
Pharmaceuticals
Retail
Entertainment/Media/Hospitality
Professional Services
Energy
Healthcare
Education
Manufacturing
Government
Transportation
Other (specify):
W9 – Request for Taxpayer Identification Number and Certification
Please print and complete a W9 form and fax it to NTT America at 415-520-5962. Completing and faxing a signed W9 is required for acceptance into the NTT America Partner Programs. If you are exempt from United States taxes because you are incorporated in another country, complete the form and check the "Exempt" box.