Proscape Content Partner Application

Content Partners

Content Partner Program Application - Step 1

Application Information

Please check the appropriate box for category and level below:

Category:
DVA 6	CLM 6 **	Exemption Code
** Note: For CLM 6, you must be an agency of record (AOR) for the brand(s) on the Proscape platform or provide your exemption code.
Level:
Content Provider	Certified Content Provider	Gold Certified Content Provider

Contact Information

Please provide the appropriate agency information below:

Legal Corporate Name :
Trading Name (if different) :
Address 1 :
Address 2 :
City :
State/Province :
Postal Code :
Country :
Phone :
Fax :
Web Address :
Form of Entity :

(ex: corporation, limited liablity company)
Ownership Structure :

(If you are a member of a network or owned by another entity, please specify)
Jurisdiction of Company :

(State and/or Country of legal formation)
Number of Employees :
Number of Accounts :

Content Partner Program Application - Step 2

Services Mix

Please enter the appropriate percentages of services below:

Contact Information

Please provide specific information for each appropriate contact:

Primary Contact for Proscape relationship

Primary Contact for information technology matters (computer systems and setup for training)

Contact Person to receive inquiries from existing or potential clients

Contact Person to receive notices under the Proscape Content Partner Agreement

Content Partner Program Application - Step 3

Client Contact Information

Please provide information specific to the client(s) for whom you are (or will be) working on the Proscape platform:

Client 1:

Company Name :
Primary Contact :
Title :
Address 1 :
Address 2 :
City :
State :
Postal Code :
Country :
Contact Phone :
Contact Email :
Brands Supported :
Are you the AOR for any of the brands? If so, please specify.
As of what date is the client requesting your services for their Proscape program?
What specific services has the client requested your firm to perfom?

Client 2:

Company Name :
Primary Contact :
Title :
Address 1 :
Address 2 :
City :
State :
Postal Code :
Country :
Contact Phone :
Contact Email :
Brands Supported :
Are you the AOR for any of the brands? If so, please specify.
As of what date is the client requesting your services for their Proscape program?
What specific services has the client requested your firm to perfom? :

Client 3:

Company Name :
Primary Contact :
Title :
Address 1 :
Address 2 :
City :
State :
Postal Code :
Country :
Contact Phone :
Contact Email :
Brands Supported :
Are you the AOR for any of the brands? If so, please specify.
As of what date is the client requesting your services for their Proscape program?
What specific services has the client requested your firm to perfom?

Proscape Accredited Individuals

If you employ any individuals who are currently accredited by Proscape, please list them below:

Employee 1:

Employee 2:

Employee 3:

<< Return To Step 2 |


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