Memetica :: Partnership Initiation Form

Contact information
Title	First name	Last name

Company name	Unit, street number and street name

City	Province or state	Postal or zip code

Country

Telephone number	Email address	Company Website

Company details
Is your company public or private?
Private Public
If your company is public, please provide its symbol

How many customers does your company have, worldwide?

How many employees does your company have, worldwide?

What is your company's estimated gross revenue for this fiscal year?

Please briefly describe your company's products and services

Please briefly describe your company's positioning in its market (addressing such things as price, quality and competition)

Please briefly describe your company's key business relationships (such as partners and clients)

Please describe the nature of the partnership you would like to establish with Memetica over both the short and long term

Please check any of the following areas you believe apply to your partnerhsip request
Silent partnership: You want Memetica to be a back-end provider for your clients Technology vendor: You have technology that could benefit Memetica's clients Content provider: You have content that could benefit Memetica's clients Sales: You would like to provide front-end sales for Memetica
Please provide any additional information, if necessary