Black Box Digital Signage Certification Program Enrollment Application

Please complete the enrollment application below. Within 24 hours of submitting your enrollment application, you’ll know whether your application is approved.

NOTE: The Black Box Digital Signage Certification Program is available only to qualified U.S. reseller or system integrator companies. At this time, the program is not available outside of the United States. If you are not an existing authorized Black Box Reseller or Integrator, you will be required to submit an enrollment packet. Black Box reserves the right to refuse enrollment to any current, past, or prospective member (individual or organization account).

1. Please enter your contact information:

* Denotes required field. ** Required for U.S. and Canada.

First Name:

Last Name:

Title:

Company Name:

Address 1:

Address 2:

Mail Stop/Suite/Building:

City:

State or Province:

* *

Zip or Postal Code:

* *

Country:

E-mail:

Telephone:

Ext:

Fax:

Is this a business or a home address?

Web site:

2. Please answer a few questions about your business:

Which category best describes your business?	Reseller System Integrator Other
If Other, please specify:

Do you specialize in any
particular verticals?

Do you currently offer or provide
digital signage?

Yes

If yes, whose digital signage
solution(s) do you offer?

How many digital signage solutions have you sold in the past 12 months?

Do you provide installation services?

Yes

Are you an existing Black Box customer?

Yes

Thank you very much for your time. We look forward to working with you!

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