ImmerVision Enables® Program
for Independent Software Vendors

APPLICATION FORM (VSA)

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 finalizethe enrollment process and provide you with the necessary documents 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)
Submitted date:
Received date

2.Contact Information

Executive Contact (main 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 (person who will sign the ImmerVision Enables SDK agreement)
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 currently 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.Product Information

Do you own or have total access to the product source code? / Yes No - If no, please fill outSection 6
Solution Brand / Model/
Version(1) / Operating Systems / IDE(2) / Programming
Language(3) / Does your solution currently support PTZ in playback? (ex: used for mega pixel camera applications)
Does your solution(s) offer 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 camera brand and which type of lens your solution can display digitally corrected images (dewarped)
(1)Planned Release Version that will include the ImmerVision Enables 360° functionality
(2)Integrated Development Environment (e.g. Microsoft Visual Studio, Borland C++ Builder, etc.)
(3)e.g. C, C++, C#, etc.

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? (owner of the source code)
Third Party URL or contact info:
Country:
Is this solution developed specifically for you, or is it an OEM/White Label product with your name on it?
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.Development Schedule

Is this integration part of a planned revision to your software or is it specific to only include 360° functionality? / Planned Release Specific Release
Planned date to commence integration
Would you like the assistance of an ImmerVision Engineer to kickoff the integration? / Yes No
What is the planned release date of your new version with ImmerVision Enables 360° panomorph lenses support?
Do you plan at this time to integrate other 360° camera solutions using fisheye or catadioptric/mirror type of lenses?

8.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_VSA_AF-140327.doc