Demo Pool Program Program Registration ProductVendors*Mist SystemsJuniper NetworksCommscope/RuckusSonicWallPulse SecureAvailable SKU'sAP41-USAP43-USSelect all that applyAvailable SKU'sEX2300-24PEX2300-24TEX2300-48TEX2300-C-12PEX2300-C-12TEX2300-C-RMKEX3400-24TEX3400-48PEX3400-48TEX4300-24PEX3400-48MPEX4600-40F-AFIEX4600-40F-AFOEX-SFP-10GE-DAC-5MEX-SFP-1GE-SXJATP700-AC-ALLQFX5100-48T-AFOQFX5110-48S-AFOQFX5120-32C-AFOQFX5200-48Y-AFOSRX1500SRX1500-ACSRX300SRX320SRX320-POESRX320-SYS-JESRX340SRX345SRX380-P-SYS-JB-ACSelect all that applyAvailable SKU's901-1205-US00901-R310-US02901-R710-US00902-0173-US009U1-R510-US009U1-R610-US009U1-R710-US00ICX7150-C12P-2X10GRICX7150-C12P-2X10GR-AICX7150-C12P-2X1GH510Select all that applyAvailable SKU'sNSA2650Available SKU'sPSA300c-NFRPartner DetailsCompany Name*Customer NumberCompany Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Shipping Address*Same as Company AddressDifferent Than Company AddressShipping Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Contact Name* First Last Email* Phone*Sales Representative* First Last Opportunity DetailsPlease select*End-User POCInternal UseBusiness Case*Terms & ConditionsThis device(s) is property of Securematics, Inc. and is shipped to the customer on the terms that the equipment will be shipped back to Securematics within 60 days from the date of original shipment, and in the same condition that the device(s) was shipped by Securematics to the customer.If the device(s) is not returned back in the stipulated time period, the customer is liable to immediate payment of the device(s) at list price.Device(s) must be returned in its original packing and with all the accessories. The return will not be accepted if the device(s) is not received back in working condition or is not sent back in its original packing, at which time an invoice will be issued for payment immediately. Device(s) must be returned in its original packing and with all the accessories.Securematics will charge a 15% restocking fee if any of the accessories are missing from the box. In case of a dispute, the decision taken by Securematics management will be final and will be binding on all involved. In order to avoid any issues / restocking fees, the customer is encouraged to get the device(s) to their warehouse for inspection before shipping it back to Securematics.All shipping costs are paid by the customer.Other Securematics Standard Terms and Conditions apply as listed on www.securematics.com/termsandconditionsPlease make sure to reset all the configurations/ passwords on the devices and restore the device to the original factory mode.Do you agree with the terms and conditions?* I agree Online SignatureBy signing this, you agree to the following: Customer is liable to pay list price for the device(s) if not returned in the stipulated time period.Partner agrees to return all demo equipment per the Terms and Conditions. Please return in same packaging and condition it was shipped in and return demo equipment at the end of the demo period to 1135 Walsh Ave. Santa Clara, Ca 95050 .Securematics is not responsible for return shipping costs.Please reset all configurations and passwords on the device and restore the device to the original factory mode.Type Your Name* First Last Date* Date Format: MM slash DD slash YYYY CAPTCHA
