IP-PBX Gateway Information Request

This Form cannot be submitted until the missing fields (labelled below in red) have been filled in
I WANT TO FIND OUT MORE!
Please note that all fields followed by an asterisk must be filled in.
First Name*
Last Name*
E-Mail Address*
Business Phone*
Fax
Business Name*
Primary Business Street Address*
Primary Business City*
Primary Business State
Primary Business Zip Code
Number of Office Locations*
Locations*
Years in Business*
Current TelCo Service Provider*
Line Type:*
Number Of Current Phone Lines*
Number of Fax lines:*
Monthly Telephone Line(s) Expense*
Monthly International Calling Expense*
Monthly Long Distance Calling Expense*
How Important Is Long Distance Calling?*
Number of 800 Numbers*
In-Bound 800# Service Provider
800 Number Expense
Internet Service Provider*
Type of Internet Connection*
Monthly Internet Service Expense*
Broadband Speed*
Does this business currently use a PBX phone system?*
Age of Equipment*
Has your business considered replacing/upgrading the PBX phone system?*
Timeframe for Deployment
Has your business considered implementing VoIP services?*
Timeframe for Deployment
Does your business have a general understanding of VoIP technology?*
Comments/Notes
Please enter the word that you see below.

I WANT TO FIND OUT MORE!