SilverPartners Form

<body onload="preloadImages();" background="../img/background_old.jpg" onload="sprachauswahl('en')" bgproperties="fixed"> <div align="center"> <table width="995" border="0" cellspacing="0" cellpadding="0"> <tr height="121"> <td height="121"> </td> </tr> <tr> <td background="../buttons/button_back.jpg"> <table width="995" border="0" cellspacing="0" cellpadding="0"> <tr> <td align="center"><a onmousedown="changeImages( /*CMP*/'home_button2',/*URL*/'../buttons/home_d_button.gif');return true" onmouseup="changeImages( /*CMP*/'home_button2',/*URL*/'../buttons/home_d_button.gif');return true" onmouseover="changeImages( /*CMP*/'home_button2',/*URL*/'../buttons/home_d_button.gif');return true" onmouseout="changeImages( /*CMP*/'home_button2',/*URL*/'../buttons/home_button.gif');return true" href="../home.html"><img src="../buttons/home_button.gif" alt="" name="home_button2" border="0"></a></td> <td align="center"><a onmousedown="changeImages( 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onmousedown="changeImages( /*CMP*/'contact_button',/*URL*/'../buttons/contact_d_button.gif');return true" onmouseup="changeImages( /*CMP*/'contact_button',/*URL*/'../buttons/contact_d_button.gif');return true" onmouseover="changeImages( /*CMP*/'contact_button',/*URL*/'../buttons/contact_d_button.gif');return true" onmouseout="changeImages( /*CMP*/'contact_button',/*URL*/'../buttons/contact_button.gif');return true" href="../contact.html"><img src="../buttons/contact_button.gif" alt="" name="contact_button" border="0"></a></td> </tr> </table> </td> </tr> </table> <h2 class="formtext"><font size="6">Kameleon Systems International Certified Partner Program Application - Silver Level</font></h2> <p class="formtext">Please fill this application form and click the "Submit" button. The fields marked by ' * ' are required.</p> </div> <form method="POST" action="http://81.223.119.123/MAIL/FMPro" name="eingabe1"> <input type="hidden" name="-DB" value="kameleonpartner.fp3"> <input type="hidden" name="-Format" value="SilverPartnersret.htm"> <input type="hidden" name="-Layout" value="Liste"> <input type="hidden" name="-new"> <input type="hidden" name="-Script" value="mail"> <p class="formtext">*First Name: <input type="text" name="firstName" size="24" onblur="kontrolle(0)"> *Last Name: <input type="text" name="lastName" size="48" onblur="kontrolle(1)"></p> <p class="formtext">*Maternal Name: <input type="text" name="maternalName" size="44" onblur="kontrolle(2)"></p> <table border="0" cellspacing="0" cellpadding="5"> <tr> <td class="formtext">*Address 1:</td> <td class="formtext"><input type="text" name="Adress1" size="89" onblur="kontrolle(3)"></td> </tr> <tr> <td class="formtext">Address 2:</td> <td class="formtext"><input type="text" name="Adress2" size="89" onblur="kontrolle(4)"></td> </tr> <tr> <td class="formtext">Address 3:</td> <td class="formtext"><input type="text" name="Adress3" size="89" onblur="kontrolle(5)"></td> </tr> </table> <table border="0" cellspacing="0" cellpadding="5"> <tr> <td class="formtext" nowrap>*City:</td> <td class="formtext"><input type="text" name="City" size="30" onblur="kontrolle(6)"></td> <td class="formtext">*State:</td> <td class="formtext"><input type="text" name="State" size="47" onblur="kontrolle(7)"></td> </tr> <tr> <td class="formtext" nowrap>*Postal Code:</td> <td class="formtext"><input type="text" name="postCode" size="24" onblur="kontrolle(8)"></td> <td class="formtext">*Country:</td> <td class="formtext"><input type="text" name="Country" size="47" onblur="kontrolle(9)"></td> </tr> <tr> <td class="formtext" nowrap>*Phone (home):</td> <td class="formtext" colspan="3"><input type="text" name="PhoneHome" size="30" onblur="kontrolle(10)"></td> </tr> <tr> <td class="formtext" nowrap>Phone (cell):</td> <td class="formtext" colspan="3"><input type="text" name="PhoneCell" size="30" onblur="kontrolle(11)"></td> </tr> <tr> <td class="formtext" nowrap>Fax:</td> <td class="formtext" colspan="3"><input type="text" name="Fax" size="30" onblur="kontrolle(12)"></td> </tr> </table> <p class="formtext">*e-mail: <input type="text" name="email" size="102" onblur="kontrolle(13)"></p> <p class="formtext">Languages:</p> <table border="0" cellspacing="2" cellpadding="5"> <tr> <td class="formtext">*Spanish:</td> <td class="formtext"><input type="radio" name="spanish" value="basic" checked onblur="kontrolle(14)"> Basic</td> <td class="formtext"><input type="radio" name="spanish" value="medium" onblur="kontrolle(15)"> Medium</td> <td class="formtext"><input type="radio" name="spanish" value="fluent" onblur="kontrolle(16)"> Fluent</td> <td class="formtext"><input type="radio" name="spanish" value="native" onblur="kontrolle(17)"> Native</td> </tr> <tr> <td class="formtext">*English:</td> <td class="formtext"><input type="radio" name="english" value="basic" checked onblur="kontrolle(18)"> Basic</td> <td class="formtext"><input type="radio" name="english" value="medium" onblur="kontrolle(19)"> Medium</td> <td class="formtext"><input type="radio" name="english" value="fluent" onblur="kontrolle(20)"> Fluent</td> <td class="formtext"><input type="radio" name="english" value="native" onblur="kontrolle(21)"> Native</td> </tr> <tr> <td class="formtext"><input type="text" name="language1" size="10" onblur="kontrolle(22)"></td> <td class="formtext"><input type="radio" name="lang1" value="basic" checked onblur="kontrolle(23)"> Basic</td> <td class="formtext"><input type="radio" name="lang1" value="medium" onblur="kontrolle(24)"> Medium</td> <td class="formtext"><input type="radio" name="lang1" value="fluent" onblur="kontrolle(25)"> Fluent</td> <td class="formtext"><input type="radio" name="lang1" value="native" onblur="kontrolle(26)"> Native</td> </tr> <tr> <td class="formtext"><input type="text" name="language2" size="10" onblur="kontrolle(27)"></td> <td class="formtext"><input type="radio" name="lang2" value="basic" checked onblur="kontrolle(28)"> Basic</td> <td class="formtext"><input type="radio" name="lang2" value="medium" onblur="kontrolle(29)"> Medium</td> <td class="formtext"><input type="radio" name="lang2" value="fluent" onblur="kontrolle(30)"> Fluent</td> <td class="formtext"><input type="radio" name="lang2" value="native" onblur="kontrolle(31)"> Native</td> </tr> <tr> <td class="formtext"><input type="text" name="language3" size="10" onblur="kontrolle(32)"></td> <td class="formtext"><input type="radio" name="lang3" value="basic" checked onblur="kontrolle(33)"> Basic</td> <td class="formtext"><input type="radio" name="lang3" value="medium" onblur="kontrolle(34)"> Medium</td> <td class="formtext"><input type="radio" name="lang3" value="fluent" onblur="kontrolle(35)"> Fluent</td> <td class="formtext"><input type="radio" name="lang3" value="native" onblur="kontrolle(36)"> Native</td> </tr> </table> <p class="formtext">Education:</p> <table border="0" cellspacing="0" cellpadding="5"> <tr> <td class="formtext">Period</td> <td class="formtext">School</td> <td class="formtext">Degree</td> <td class="formtext">Graduated</td> </tr> <tr> <td class="formtext" align="right">*<input type="text" name="ed1Period" size="12" onblur="kontrolle(37)"></td> <td class="formtext"><input type="text" name="ed1School" size="27" onblur="kontrolle(38)"></td> <td class="formtext"><input type="text" name="ed1Degree" size="32" onblur="kontrolle(39)"></td> <td class="formtext"><input type="radio" name="ed1Graduated" value="yes" checked onblur="kontrolle(40)"> Yes <input type="radio" name="ed1Graduated" value="No" onblur="kontrolle(41)"> No</td> </tr> <tr> <td class="formtext" align="right"><input type="text" name="ed2Period" size="12" onblur="kontrolle(42)"></td> <td class="formtext"><input type="text" name="ed2School" size="27" onblur="kontrolle(43)"></td> <td class="formtext"><input type="text" name="ed2Degree" size="32" onblur="kontrolle(44)"></td> <td class="formtext"><input type="radio" name="ed2Graduated" value="yes" onblur="kontrolle(45)"> Yes <input type="radio" name="ed2Graduated" value="No" checked onblur="kontrolle(46)"> No</td> </tr> <tr> <td class="formtext" align="right"><input type="text" name="ed3Period" size="12" onblur="kontrolle(47)"></td> <td class="formtext"><input type="text" name="ed3School" size="27" onblur="kontrolle(48)"></td> <td class="formtext"><input type="text" name="ed3Degree" size="32" onblur="kontrolle(49)"></td> <td class="formtext"><input type="radio" name="ed3Graduated" value="yes" onblur="kontrolle(50)"> Yes <input type="radio" name="ed3Graduated" value="No" checked onblur="kontrolle(51)"> No</td> </tr> <tr> <td class="formtext" align="right"><input type="text" name="ed4Period" size="12" onblur="kontrolle(52)"></td> <td class="formtext"><input type="text" name="ed4School" size="27" onblur="kontrolle(53)"></td> <td class="formtext"><input type="text" name="ed4Degree" size="32" onblur="kontrolle(54)"></td> <td class="formtext"><input type="radio" name="ed4Graduated" value="yes" onblur="kontrolle(55)"> Yes <input type="radio" name="ed4Graduated" value="No" checked onblur="kontrolle(56)"> No</td> </tr> <tr> <td class="formtext" align="right"><input type="text" name="ed5Period" size="12" onblur="kontrolle(57)"></td> <td class="formtext"><input type="text" name="ed5School" size="27" onblur="kontrolle(58)"></td> <td class="formtext"><input type="text" name="ed5Degree" size="32" onblur="kontrolle(59)"></td> <td class="formtext"><input type="radio" name="ed5Graduated" value="yes" onblur="kontrolle(60)"> Yes <input type="radio" name="ed5Graduated" value="No" checked onblur="kontrolle(61)"> No</td> </tr> </table> <p class="formtext">Work Experience:</p> <table border="0" cellspacing="2" cellpadding="5"> <tr> <td class="formtext">Period</td> <td class="formtext">Employer</td> <td class="formtext">Position</td> </tr> <tr> <td class="formtext" align="right">*<input type="text" name="work1Period" size="12" onblur="kontrolle(62)"></td> <td class="formtext"><input type="text" name="work1Employer" size="27" onblur="kontrolle(63)"></td> <td class="formtext"><input type="text" name="work1Position" size="32" onblur="kontrolle(64)"></td> </tr> <tr> <td class="formtext" align="right"><input type="text" name="work2Period" size="12" onblur="kontrolle(65)"></td> <td class="formtext"><input type="text" name="work2Employer" size="27" onblur="kontrolle(66)"></td> <td class="formtext"><input type="text" name="work2Position" size="32" onblur="kontrolle(67)"></td> </tr> <tr> <td class="formtext" align="right"><input type="text" name="work3Period" size="12" onblur="kontrolle(68)"></td> <td class="formtext"><input type="text" name="work3Employer" size="27" onblur="kontrolle(69)"></td> <td class="formtext"><input type="text" name="work3Position" size="32" onblur="kontrolle(70)"></td> </tr> <tr> <td class="formtext" align="right"><input type="text" name="work4Period" size="12" onblur="kontrolle(71)"></td> <td class="formtext"><input type="text" name="work4Employer" size="27" onblur="kontrolle(72)"></td> <td class="formtext"><input type="text" name="work4Position" size="32" onblur="kontrolle(73)"></td> </tr> <tr> <td class="formtext" align="right"><input type="text" name="work5Period" size="12" onblur="kontrolle(74)"></td> <td class="formtext"><input type="text" name="work5Employer" size="27" onblur="kontrolle(75)"></td> <td class="formtext"><input type="text" name="work5Position" size="32" onblur="kontrolle(76)"></td> </tr> <tr> <td class="formtext" align="right"><input type="text" name="work6Period" size="12" onblur="kontrolle(77)"></td> <td class="formtext"><input type="text" name="work6Employer" size="27" onblur="kontrolle(78)"></td> <td class="formtext"><input type="text" name="work6Position" size="32" onblur="kontrolle(79)"></td> </tr> </table> <p class="formtext">*Why do you want to become a Kameleon Certified Partner?</p> <p class="formtext"><textarea name="WhyPartner" rows="7" cols="100" onblur="kontrolle(80)"></textarea></p> <p class="formtext">*What is your experience in the computer industry?</p> <p class="formtext"><textarea name="WhatExperience" rows="5" cols="100" onblur="kontrolle(81)"></textarea></p> <p class="formtext">*What kind of business contacts do you have that would be interested in purchasing Kameleon?</p> <p class="formtext"><textarea name="WhatContacts" rows="6" cols="100" onblur="kontrolle(82)"></textarea></p> <p class="formtext">*Do you own a computer?   <input type="radio" name="Computer" value="yes" checked onblur="kontrolle(83)"> Yes <input type="radio" name="Computer" value="No" onblur="kontrolle(84)"> No</p> <p class="formtext">Provide 3 references that we can check.</p> <table border="0" cellspacing="0" cellpadding="5"> <tr> <td class="formtext">Name</td> <td class="formtext">Telephone</td> <td class="formtext">Title</td> </tr> <tr> <td class="formtext" align="right">*<input type="text" name="Ref1Name" size="29" onblur="kontrolle(85)"></td> <td class="formtext" align="right"><input type="text" name="Ref1Tel" size="15" onblur="kontrolle(86)"></td> <td class="formtext" align="right"><input type="text" name="ref1Title" size="32" onblur="kontrolle(87)"></td> </tr> <tr> <td class="formtext" align="right">*<input type="text" name="Ref2Name" size="29" onblur="kontrolle(88)"></td> <td class="formtext" align="right"><input type="text" name="Ref2Tel" size="15" onblur="kontrolle(89)"></td> <td class="formtext" align="right"><input type="text" name="ref2Title" size="32" onblur="kontrolle(90)"></td> </tr> <tr> <td class="formtext" align="right">*<input type="text" name="Ref3Name" size="29" onblur="kontrolle(91)"></td> <td class="formtext" align="right"><input type="text" name="Ref3Tel" size="15" onblur="kontrolle(92)"></td> <td class="formtext" align="right"><input type="text" name="ref3Title" size="32" onblur="kontrolle(93)"></td> </tr> <tr> <td class="formtext" align="right"><input type="text" name="Ref4Name" size="29" onblur="kontrolle(94)"></td> <td class="formtext" align="right"><input type="text" name="Ref4Tel" size="15" onblur="kontrolle(95)"></td> <td class="formtext" align="right"><input type="text" name="ref4Title" size="32" onblur="kontrolle(96)"></td> </tr> </table> <p class="formtext">I authorize Kameleon Systems International (606808 CANADA INC.) to verify the information that I have given in this document. I attest that this information is true, and I understand that it will be kept confidential.</p> <p class="formtext">*   <input type="radio" name="authorize" value="yes" checked onblur="kontrolle(97)"> Yes <input type="radio" name="authorize" value="No" onblur="kontrolle(98)"> No</p> <p class="formtext" align="center"><input name="-new" type="submit" value="Submit" onclick="return kontrolle(999)"></p> </form> <p class="formtext"><font size="-2">Submitting the above information does not engage Kameleon Systems International (606808 CANADA INC.) in any contractual obligations with the applicant. Kameleon Systems International (606808 CANADA INC.) reserves the right to only contact selected candidates for an interview. Kameleon Systems International (606808 CANADA INC.) normally replies to selected candidates within one week of application. Selected candidates will be required to take a Kameleon Certified Sales Technician course and pass the Kameleon Sales Technician certification examination, prior to becoming Kameleon Certified Partners. All selected candidate will be required to sign a Non-Disclosure Agreement (NDA) with Kameleon Systems International (606808 CANADA INC.), and certified candidates will be required to sign a Kameleon Certified Partner agreement with Kameleon Systems International (606808 CANADA INC.).</font></p> <center> <hr> <table width="100%" border="0" cellspacing="0" cellpadding="0"> <tr> <td valign="top"><font color="black">Webmaster:</font> <a href="../../english/mail.html?gerhardus&keg"><img src="../img/mail_gerhardus.gif" alt="" height="13" width="170" border="0"></a></td> <td align="right" valign="top"> <h5>© 2002-2007 <a href="../../english/mail.html?info&kameleon">Kameleon Systems International</a> Inc.</h5> </td> </tr> </table> </center> <script type="text/javascript"> </script> </body>