To apply for membership to Mitel's new Consultant Liaison Program, complete the following profile. All fields in the "Personal Information" section as well as those marked with an *are mandatory.


Note: All fields marked with an asterisk * are mandatory
* Salutation * Job Title
* First Name * Job Role
* Last Name

* Telephone number
* Fax number
* E-mail address * Confirm E-mail address

* Organisation Name
Office Address
Home Address
* Address1
Address2
Address3
* City
* Country * State/Province
* Zip/Postal Code
Years in Business*
How Many Clients on an Annual Basis*
Number of Employees
1-10
11-25
26-50
Over 50
Firm Scope
Local
Regional
National
International
Area(s) of Technical / Product Specialisation*
How did you hear about this program?*
What size of organisation does your company usually represent*
Large (> 500 employees)
Medium (101-499 employees)
Small (10-100 employees)
End Users / Home Business
Of the last ten clients, how often did you recommend Mitel?

Other Vendors Recommended:
Is there anything else we should know?

Choose your user id:
Choose your password:
Confirm your password:
Enter a reminder for your password:
(ex: My son's nickname?)


Mitel Networks will process by computer (or otherwise) information requested on this form as a result of this enquiry. In addition, it may be necessary to pass the information provided onto Strategic Partners, Resellers & Distributors of Mitel Networks in order to enable Mitel Networks and / or its representatives to provide the information requested.
Additionally, Mitel Networks would occasionally like to keep you informed about products and information which may be of interest to you, either by mail, telephone, fax or e-mail.
If you DO wish the personal data to be used for this particular purpose then tick the appropriate boxes: all e-mail telephone fax post sms
If you DO NOT wish the personal data to be used for this purpose then tick this box