Deal Registration Form

Reseller Name *

Lead Owner *

Email *

Organization Name *

Primary Lead Contact *

Contact Telephone *

Contact Email *

Industry *

Product Interest *

RollBack Rx Professional

RollBack Rx Server Edition

Reboot Restore Rx Pro

Drive Cloner Rx

Number of Licenses *

Does the customer have a budget? *

Is the customer an existing Horizon DataSys user? *

Estimated value of deal *

Estimated closed date *

Additional Notes