ImmerVision Enables® Program
for Independent Software Vendors

APPLICATION FORM (CPA and CEA)

To apply for ImmerVision Enables Program for ISV giving you access to the SDK and ImmerVision Enables Stamp, please fill out this application (please note that all response boxes have been formatted to expand when text is entered). This form provides us with the company and product information necessary to properly review your application. Please email completed form to .

After the review has been completed, you will be contacted via email to finalize the enrollment process and provide you with the necessary document to move forward with the integration.

/ Please note that all fields must be filled out for your application to be reviewed.
Please be sure to complete either Section 5 or 6.
All information supplied to ImmerVision in regards to this Application Form
will be treated with the utmost confidentiality.

1.  Company Information

Company Name:
Street Address:
City:
State:
Country:
Zip Code:
Phone Number:
Fax Number:
Company URL:
Holding Company
(if the company is a subsidiary of another company please indicate the name of the Holding Company)

2.  Contact Information

Executive Contact (person with whom ImmerVision will communicate concerning this application)
Honorific (Mr., Mrs., etc.)
Name:
Title:
Phone Number:
Fax Number:
Email:
License Agreement Authorized Signatory
Honorific (Mr., Mrs., etc.)
Name:
Title:
Phone Number:
Fax Number:
Email:
Business Development / Alliances Contact
Honorific (Mr., Mrs., etc.)
Name:
Title:
Phone Number:
Fax Number:
Email:
Marketing Contact
Honorific (Mr., Mrs., etc.)
Name:
Title:
Phone Number:
Fax Number:
Email:
Technology / Development Contact
Honorific (Mr., Mrs., etc.)
Name:
Title:
Phone:
Fax Number:
Email:
Sales Contact
Honorific (Mr., Mrs., etc.)
Name:
Title:
Phone Number:
Fax Number:
Email:

3.  Corporate Information

Company Profile:
Please provide a brief overview of your company.
Customer Profile:
Please provide a brief description of your typical customers.
Main Competitors:
Year Established:
Public/Private:
Number of Employees:
What partnership/alliance programs are you a member of?

4.  Sales Information

What is the structure and size of your sales organization? (direct, resellers, OEMs, etc.)
What are your target markets? (geographic and industry)
Total number of customers:
Which countries are your customers concentrated in?

5.  Project Information

Do you own or have total access to the product source code? / Yes No - If no, please fill out Section 6
Please describe how your application will be used, as well as, the project scope of the integration of ImmerVision Enables 360o immersive functionality
Hardware Platform
Operating System
IDE (e.g. Microsoft Visual Studio, Borland C++ Builder, etc.)
Programming Language (e.g. C, C++, C#, etc.)
Have any of your projects offered digital image correction (dewarping) of 360° camera solutions using fisheye or catadioptric/mirror type of lenses? / Yes No - If yes, please answer next question
Please indicate with which brand camera and which type of lens your solution can display digitally corrected images (dewarped)

6.  Third Party Development Information

This section addresses questions related to Third Party development. If this doesn’t apply to you, please make sure you’ve filled out Section 5.
Who is your Third Party solution developer:
Third Party URL or contact info:
Country:
Is this an exclusive development?
Product Development Cycle:
Please provide a brief overview of the product development cycle from the moment you want to add specific functionality to the time your Third Party developer releases an update/new version (e.g. steps, timeline, etc.)

7.  For ImmerVision Internal Use

Technical Requirement Verified
Date / Name / Signature
Business Requirement Verified
Date / Name / Signature
Legal Requirement Verified
Date / Name / Signature

IVE_Program_ISV_CPA-CEA_AF-140327.doc