Integrators Application

Integrator Application Form

If you are a company and would like to be qualified for System Integrator or quantity pricing for your business needs, please fill out this online application and fax a copy of your business license (and your state resale license if you are reselling) to (949)380-0888. You can skip the EIN and State Resale Number if you are located outside of the United States. One of our account managers will contact you as soon as we received all the required information and documentation.

*This application must be completed in full. Incomplete applications will be rejected. Completion of this application does not imply that you have been accepted as a XENARC Authorized System Integrator.

Company Information:

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Project Details:

Required VIDEO Inputs (Select all that apply):

Required Accessories:

Describe usage purpose and environment:

 
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