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Company Name:

Contact Name:

Contact Email:

IT Contact Email:

# number of lines needed for inbound & outbound dialing:

Do you have Private #'s for Employees? If so, how many?:

Does your company have a fax? If so, how many?:

Would your company be interested in EFAX?:
Yes No

How many physical in-house phones do you have?:

Do you have remote locations?:
Yes No

If yes to above, indicate how many physical phones would be needed:

Do you have a Broadband Internet Connection?:
Yes No

Who is your broadband provider?:

Does your company have an Alarm System, ATM, Credit Card Machine, Elevator, Pay Phone, Modem, Fire Alarm?:
Yes No

If YES, how many items above require Analog phone lines?: