Black Box Deal Registration Program International Application

WIN MORE BUSINESS...
when you recommend Black Box® products to your customers. With our Deal Registration Program, once approved, you’re guaranteed to receive the largest discount Black Box extends to any reseller or integrator participating in Black Box’s standard reseller/integrator discount program at the time of your submission of this application. The discount will only be applicable to the opportunity described in this application. It provides the lowest Black Box price, and it’s yours!

All you need to do is submit your completed Deal Registration Application for $25,000 or more of Black Box brand products (see form below). If you’re first, you’ll have your approval within 72 hours!

Product lines include:
• Adapters • Cables – Category 5, 5e, 6, 6a, & 7 – Fiber – VGA – Custom	• Cable Management • Digital Signage & Multimedia • Extenders • KVM Switches – (KVM over IP, too!)	• Patch Panels • Racks and Cabinets • Tools and Testers • Wallplates And more!

Need help specifying Black Box products?
Talk to one of our dedicated Tech Support experts at 724-746-5500. They’re available 24/7.

Black Box Network Services Deal Registration Program — International Application

Please submit this form along with project details so that this opportunity can be officially registered to your company. The first Partner to register an opportunity will receive the largest discount Black Box extends to any reseller or integrator participating in Black Box’s standard reseller/integrator discount program at the time of your submission of this application. Such discount will only be applicable to the opportunity described in this application.

Because this registration is intended to protect our Partners’ efforts in promoting and specifying Black Box products, any BBDR Program Application received after an RFQ/RFP has been released will not be approved without prior consent from Black Box.

NOTE: This Deal Registration Program applies only to opportunities in Small, Medium, and Large Businesses that involve the purchase and sale of Black Box labeled products with a total list price greater than $25,000.

Your Information

Company Name:

Customer Number:

City:

State or Province:

Postal Code:

First Name:

Last Name:

Contact Number:

E-mail Address:

Phone:

Your Customer/End User Information

Company Name:

Contact Name:

E-mail:

Phone:

Address 1:

Address 2:

Address 3:

City:

State:

Zip:

Project Information

Project Name:

Project Status:

Are You Working with
Anyone at Black Box?

No - Assign Specialist

If Yes, Who?

Do You Require Pre-Sales
Assistance from Black Box?

Vertical Market:

Will Installation Services
Be Needed?

Project Description:

Estimated Budget
Approval Date:

Estimated Purchase Date:

Black Box Product Registration

Product Category	Product Description	Quantity	BBx Product No.	Unit Price	Ext. Price	BBunit. Price	BBext. Price

Or, if you need more space, click here to download a spreadsheet and attach it to an e-mail to International@BlackBox.com.

Competitor Information

Competitor Name	Competitor Product / Part Number	Competitor Product / Part Description	Estimated Price

Who Provided a Price Quote for a Competing Solution?

Yes, I have read and agree to the terms and conditions of this deal registration.

Thank you for registering this deal. Please send any additional project details to International@BlackBox.com. You will receive a response in 72 hours. EXPIRATION: This registration expires 90 days from the approval date. Extensions and rollout exemptions may be requested.
CS&S-F-034 Rev1 (11/7/11)	Company Confidential