Information Request Form
For Dell Internal Use Only

Your Name*
Your Region*
Your Country *
Your Dell Segment*
Your Phone Number* Your Email Address*
CC Email Address/es (separate with ";")

Product Inquiry Type* Details of Request
* = Required Field
Select Product/s

Active Administrator
ActiveRoles Quick Connect
ActiveRoles Server
AD Management #
AD Migration #
AppAssure Backup & Replication
Authentication Services
Authorization Policy Server
Backup & Disaster Recovery Suite
Stat for Oracle E-Business and PeopleSoft
DB Performance #
Dell DL4000

Enterprise Single Sign-on
Exchange Management #
Exchange Migration #
Foglight #
Foglight for Virtualization
Foglight Network Management System #
Help Desk #
Identity Manager #
Kitenga Analytics
LiteSpeed #
Mobile Workforce Management Solutions
       (EMM, BYOD, K1 SaaS, Moka5)
Netvault - Backup & Recovery #
Notes Transition #
One Identity Management
One Password Manager
Privileged Account Management
Secure Copy #
Security Explorer #
SharePlex Space Manager/LiveReorg #
SharePoint #
TOAD (except SQL Server) #
TOAD SQL Server #

Don't Know

# = Primary Products in Korea, China and Japan

If this is a GCC/Channel Opportunity, please provide the following:

Partner Account Name

Affinity ID

Partner Contact Name

Partner Contact Phone Number
Partner Contact Email  

If you've selected either SALES REP INTRO or PRICE/SKU/QUOTE for inquiry type, or if this is a GCC/Channel opportunity, please provide the following:

Name of Account / End User

Affinity ID
Contact Name
Contact Email Address

Street Address

City, State or Province, Country
Zip Code/Postal Code

Contact Phone Number

What type of oppportunity is this?  

Is this opportunity already in Dell SFDC?

If Yes, provide Opportunity Number: