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The first step in becoming an Inergex partner is to fill out the form below. Upon completing the application, an Inergex partner relationship manager will review your information and respond back to you with possible next steps. All companies interested in partnering with Inergex need to fill out this form before being considered.

We look forward to finding ways to work together!

Bold Text = Required Field

Name:  
Title:  
Company:  
Address 1:  
Address 2:
City:      State:  
Zip:
Phone:
Email:    
Why do you want to partner with Inergex?
 
What types of services/products do you feel you can offer that will complement Inergex offerings?  Please describe what your services/products are in as much detail as possible.
   
What type of industries do you work in most?






If you chose Other, please enter additional information below:
How long has your company been in business?




 
Who else do you partner with that you would say is similar to Inergex?  
Within your organization, who would Inergex work with to build a long-term partner relationship?




If you chose Other, please enter additional information below: