CMP Qualification Form - North America

Motion recommends Windows Vista® Business.

If the candidate has a contractual relationship with Motion Computing, please complete this Qualification Form. If the candidate does not have a contractual relationship with Motion Computing, please complete, sign and forward the Credit Application, as well as the additional information listed on the previous page.

Company Name:

First Name:

Last Name:

Title:

Address (1):

Address (2):

City, State, Zip:

URL:

Phone:

Email:

Do you have a current contract in place with Motion Computing:

Yes

Motion Salesperson's name:

Primary Technician Name:

Current A+ Certified:

Yes

A+ Number:

Other Industry Certifications (List):

Technician Phone:

Technician Email:

Other Technician Name:

Current A+ Certified:

Yes

Other A+ Number:

Other Industry Certifications (List):

Other Technician Phone:

Other Technician Email:

Part "Ship-to" Address
(if different from above):

Executive Approval Name:

Title:

Approval Phone:

Approval Email: