Register a Customer Opportunity - cyberconIQ.com - Human Defense Platform & Advisory Services

Step 1. Register a Customer Opportunity

Use this form to register a new Customer. Please include all the required information, including details of this Customer's Administrator, who will be responsible for supporting this Customer's Participants. If you have already added your customer and Closed them, you can purchase licenses click here.

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organization_id
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team_id
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step
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- Updated Reseller Notification -
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Reseller ID
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Reseller
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Reseller's Email
Load an existing organization
If you wish to update an existing organization, select them here.
Status*
Use this field to track this Customer through your sales process.
Customers must be marked "Closed" before you can purchase licenses or create Teams.
Company / Customer Information
Company Name*
Company Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Company Website
Executive sponsor
First Last
Email
Phone
Job Title
Anticipated budget allocated
Anticipated timing of purchase decision
MM slash DD slash YYYY
Total # of employees
Total # of employees likely to consume cyberconIQ solutions
Customer Admin Details
Please identify a user as the Customer's Training Administrator. This user will be granted access to the unIQue Admin Console.
Admin's Name
First Last
Email
Phone
For Office Use
The fields below are optional, and for your use if/as needed.
Sales Representative
Customer PO
Project Number/ID

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Step 1. Register a Customer Opportunity

Company / Customer Information

Customer Admin Details

For Office Use

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