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Company:
Email Address: Use company's email only. Public domain email address (such as Gmail, Hotmail, etc.) will not be accepted.
First Name:
Last Name:
Title:
Role: Select one Executives Marketing Sales Technical
Direct Phone:
Street Address:
City:
Country: Select one United States Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Ascension Island Australia Austria Azerbaijan Azores Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia-Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote D'Ivoire Croatia Cuba Cyprus Czech Republic Dem Republic of Congo Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Faeroe Islands Falkland Islands (Malvinas) Fiji Finland France France (European Territories) French Guiana French Polynesia French Southern Territories Gabon Gambia Gaza Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam (US) Guatemala Guernsey, C.I. Guinea Guinea-Bissau Guyana Haiti Heard and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran (Islamic Republic of) Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey, C.I. Jordan Kazakhstan Kenya Kiribati Korea, Dem. People''s Rep of Korea, Republic of Kosovo Kuwait Kyrgyzstan Lao Peoples Democratic Republi Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia, Republic of Madagascar Madeira Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Fed. States of Moldova, Republic of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherland Antilles Netherlands New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestine Panama Panama Canal Zone Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Kitts and Nevis Saint Lucia Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia Spain Sri Lanka St. Helena St. Martin St. Pierre and Miquelon St. Vincent and the Grenadines Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan Tajikistan Tanzania, United Republic of test Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu U.S. Minor Outlying Islands Uganda Ukraine United Arab Emirates United Kingdom Uruguay Uzbekistan Vanuatu Vatican City State Venezuela Vietnam Virgin Islands (British) Virgin Islands (US) Wallis and Futuna Islands Western Sahara Yemen, Republic of Zambia Zimbabwe
State: Select State... Alaska Alabama Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming
State/Province: AL AK AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY AB BC MB NB NS NT NU ON PE QC SK YT NL
Territory: Select Territory... New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia Australian Capital Territory
Province: Select Province... Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory
Zip/Postal Code:
Company Website URL:
Partner Type:
Primary Area of Interest: Select one Authentication & Access Management Encryption & Key Management High Assurance Key Protection (HSM) Network & WAN Encryption
Industry: Select one Aerospace & Defence Airlines Industrial Automation Automotive Automotive Manufacturing Automotive/Agriculture/Transp/Logistics Broadcast/Media Building Business Services & Consulting CAD/CAM/EDA/PLM Chemical Computer-Aided Design and Manufacturing Computer Equipment Manufacturers Construction Construction/ Building Mgmt Consulting/Business Services/Legal Consumer Electronics Defence/Aerospace/Government Distributors E-commerce,Internet Education End User Companies – Software Protection Energy Enterprise Hardware/Software Environmental Financial Services Financial Services: Banking Financial Services: Investment/PE/VC Financial Services: Other Gaming, Entertainment Geo Information Systems Government Government (Federal) Government (Non US) Government (State/Local) Healthcare/Life Sciences High Tech Hospitality Hotel/Tourism Industrial Automation/ Machinery Information Technology Insurance Insurance: Healthcare Insurance: Property Insurance: Underwriting Insurance: Other Law Enforcement Legal Logistics Machine Building Management Manufacturing Marketing Measurement Media Medical/Healthcare Medical Imaging & Diagnostic Equipment Medical Software Mobile Networking Networking/Telecom Non Profit Oil & Gas Oil/Gas/Chemical Other Payment Processors Pharmaceutical Printing and Digital Imaging Publishing/Printing/Packaging Real Estate Research Reseller Retail Retail/Service Service Provider Software Companies System Integrator System Integrators/ Resellers Telecommunications Textiles Transportation/Logistics Unknown Utilities/Energy
Referred by: Select one Customer Thales Distributor Thales Sales Other
Preferred Distributor:
Partner's Integrated Products: Your company's product you wish to integrate Thales product with.
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I accept the
Thales OEM Partner Agreement , including “
Charter ” and any terms and conditions referenced in the agreement. By accepting the terms, you represent that you are duly authorised to sign the agreement on behalf of your organisation.