"*" indicates required fields

U.S. Based*
Due to regulatory compliance for certain contracts that we may be bound to, we currently require all partners to based in the United States.

Disqualified?

If you are reading this, your business is currently disqualified. However, we encourage you to look over the remainder of the form to see all requirements for a potential applicant.
Type of Partnership Requested:*
Select all that apply.
Please describe in detail the type of relationship you propose, and the services or products involved.
This is the name of the company as your customers may see it displayed.
This is the name of your company as registered with your government.
Name of Authorized Agent*
This person will act as an authorized agent of your company and has the power to legally bind your company to our agreement.
The direct phone number of the person authorized to legally bind to our agreement.
This is the primary phone number your customers use to contact you.
The direct email address of the person authorized to legally bind to our agreement.
This is the primary email address your customers use to contact you.
The publicly facing website for your business, products, and services.
Your business (personal for freelancers) LinkedIn profile.
Tax Number Type*
For companies, enter your EIN or TIN provided by the IRS.
For freelancers or sole proprietors, enter your social security number.
If you have a Dun and Bradstreet number, please enter it here.
If you have a CAGE number from SAM.gov please enter it here.
The date your business was started as listed with your government agency. (or your start date for freelancers)
MM slash DD slash YYYY
Registered Legal Address*
This is the address registered with your local government.
Mailing Address*
This is the address used to send correspondence via USPS.
If you are a business, we require a current business license to work with us.
Accepted file types: jpg, gif, png, pdf, Max. file size: 25 MB.
If you are a business and have insurance or a bond and you wish to share the proof, please share it here.
Drop files here or
Accepted file types: jpg, gif, png, pdf, Max. file size: 25 MB, Max. files: 3.
    Consent*
    I (the Authorized Agent and the company that I represent) understand that filling out this form does not mean that a partnership relationship has been formed. I also understand that all correspondence regarding this form is confidential and should be protected by both parties.
    This field is for validation purposes and should be left unchanged.