Thank you for your interest in SelectCore. Our success over the years has been built on our keen ability to recognize partnerships that provide an edge in helping us grow our business. We are constantly looking to establish mutually rewarding, strategic relationships with suppliers, distribution partners and other companies in our industry.

As a preliminary requirement, companies interested in partnering or doing business with SelectCore are asked to complete and submit this online form. Your responses will assist us in understanding the proposed opportunity. An appropriate executive from SelectCore will review the information provided and respond to you as soon as possible.

Title First Name
 
Last Name Company
 
Head Office Address City
 
Province Postal Code
 
Phone Number Email Address
 
Fax Number Cell Phone
 
 
Legal Corporate Name Corporate Website
 
Annual Revenue Type of Entity
 
In Buisness Since Number of Employees
 
Type of Business / Industry DUNS#
 
Market Region Have you contacted SelectCore before?
 
Urgency of opportunity  
  
 
Brief description of your company
Product/Service offerings your company provides
What is the size of your customer / subscriber base?
Please provide a brief profile of your typical customer
Does your organization serve a specific vertical market or application area
Proposed relationship with SelectCore
Please elaborate on the specific opportunity
Briefly explain why you would like to pursue a business partnership with SelectCore
How do you envision this business relationship working?
How were you referred to SelectCore?
If you have any additional questions or comments, please enter them here