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* First Name * Last Name
* Email * Phone
Title Cell Phone
* Company * Address 1
Address 2 *City
* State * Zip
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Area of Interest
Data Networking Network Security
Internetworking / TCP/IP WAN Technologies
Data Services VOICE
Internet Access Managed Services
MPLS VOIP
    
 
 

 
1) How do you primarily intend to use your T1? [required]
(check all that apply)
    Internet access
Voice
Integrated voice and data
Point-to-Point (between servers or locations)
Web or other server hosting
Video conferencing
Virtual Private Network (VPN) or Intranet
Other (please specify):
   
2) Do you currently have business Internet access or data lines? [required]
    No
Yes
    If yes, please list type of current services:
    
3) How many people will be using this business data connection simultaneously? [required] 
    0-50
50-100
100-200
200-500
500+
4) For how many business locations are you looking to set up this data service? [required]
    1
2
3-4
5+
5) How many voice lines do you need? [required]
   
6) What is your decision making timeframe? [required]
    ASAP
Within one month
In two months
More than two months
7) What type of phone system do you have? [required]
   
8) What is the five digit ZIP code for your primary office location? 
   
NOTE: We only serve U.S. businesses at this time.
9) If you do currently have dedicated data lines, are you contractually committed to your current service?

  

  No - we are not committed or do not have data lines currently
Yes - please note contract termination date:
    
10) Are your office locations properly wired for business data services?

  

  Not sure
Yes
No
11) Do you need multiple data lines?

  

  Unsure - please advise
No - we only need one line
Yes - we need multiple lines
    please note exact number:
12) Please describe, in detail, any additional requirements you may have for your dedicated business data such as VPN support, web hosting or any other data related needs.

  

 
Note: There is a 1,000 character limit for this answer.
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