Covisint - Help - Contact - Member Requested Enrollment

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Help

Member Requested Enrollment Form

Use this form if you have been requested by one of your customers or trading partners to begin using Covisint.

Please fill out the entire form to initiate the process and you will be contacted by one of our registration specialists to complete the process.

Personal Information
*		= Required
*Company Name:
*Requestor Name:
*Phone Number:
*Email:
*Office Address:
*Covisint Product(s) you have been asked to sign up for:		Covisint Connect Covisint Connect Supplier Connection Covisint Communicate Covisint Portal Services Covisint Collaborate Problem Solver

Member Company (Your Customer) Information
Your member company is the company that requested you to sign up for Covisint product(s). (GM, Ford, DaimlerChrysler, Delphi, Renault, Nissan, etc.)
*Name of Company that instructed you to join Covisint:
*Name of Employee that instructed you to join Covisint:
*Phone Number of person whom instructed you to join Covisint:

Comments:
Have you been contacted by Covisint directly?		Yes No
If yes, by whom Covisint Contact Name:
Covisint Contact Phone: