Support
Internet Access Form

* Full Name   * Email address?    
* Contact Phone:   * Job Title  
* Company Name  
Company Address


* How do you primarily intend to use your business Internet line(s)?





* Do you currently have business Internet access or T1 or T3 lines?
 

* How many people will be using this business Internet connection simultaneously?
 

* For how many business locations are you looking to set up this Internet service?
 

* What is your desired type of business Internet access?
 

* When do you intend to purchase this hosted or virtual office phone service?
 

* What are the first six digits of the telephone number beginning with the area code where Internet access will be installed?
Ex: 617-555
 

* What is the five digit ZIP code for the office location?  

* If you do currently have dedicated Internet access lines, are you contractually committed to your current service?
 

* Are your office locations properly wired for business Internet access?
 

* Do you need multiple Internet/data lines?
 

Please describe, in detail, any additional requirements you may have for your dedicated business Internet or data lines such as VPN support, web hosting or any other data related needs.

 

   

 
 
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