# Step 1: General Information

**Company Name***

**First Name**

**Last Name**

**Email***

**Company URL***

**Primary Phone Number***

### Country Codes
- 🇺🇸 United States +1  
- 🇦🇫 Afghanistan +93  
- 🇦🇱 Albania +355  
- 🇩🇿 Algeria +213  
- ... (list continues for all countries)

**Upload Logo File w/Transparent Background (SVG or PNG)***

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## Step 2: Company Overview

**Geographic Regions Served***
- North America  
- Europe  
- Asia  
- Australia/New Zealand  
- Africa  
- South America  
- Global  
- Other

**Languages in which you can provide services***
- English  
- Spanish  
- French  
- German  
- Mandarin  
- Japanese  
- Portuguese  
- Russian  
- Arabic

**Brief Description of your Company***

**Number of Employees***
- 1-5  
- 6-25  
- 26-50  
- 51-100  
- 101-500  
- 501-1000  
- 1001+

## Step 3: Customer Success Services

**Service Partner - Industries Served***
- SaaS/Software  
- Healthcare  
- Finance  
- Retail  
- Education  
- Manufacturing  
- Other

**Do you have experience working with B2B SaaS Companies?***
- Yes  
- No

**Types of Customer Success Services Offered***
- Tool/Software Implementation  
- API Development  
- Mentoring  
- Advising  
- Fractional Services  
- Hiring  
- Customer Success Strategy  
- Revenue Operations/Customer Success Operations  
- Individual Coaching  
- Team Coaching  
- Onboarding & Implementation  
- Customer Training & Education  
- Customer Success Management  
- Customer Support  
- Customer Experience Consulting  
- Health Scoring & Analytics  
- Renewal & Upsell Management  
- Other

## Step 4: Other Partners

**Are you currently partnered with other customer success platforms?***
- Yes  
- No

## Step 5: A few more questions!

**Estimated Number of Clients you serve annually?***

**How many of your clients could benefit from Vitally's solutions?***

**What attracts you to partnering with Vitally?***

**Any other information you'd like to share?**