Print this form from your browser, fill it out, then fax it to 800-872-1054

    We need the following information so that we can provide you with a proposal.

    Company Name _________________________________

    Contact Person ___________________________

    Address __________________________________

    City _____________________ State ____ Zip________

    Phone _________________________ Fax __________________________

    How many locations are there? ___________

    Do you currently have T-1 dedicated service? ________ If yes what are your monthly recurring charges? _________

    How many minutes of interstate outbound traffic do you use? ____________
    How many minutes of interstate inbound (800/888) traffic do you use? ____________
    How many minutes of intrastate outbound traffic do you use? ____________
    How many minutes of intrastate inbound (800/888) traffic do you use? ____________
    Do you have any 56K private lines or frame relay service?__________

Our proposal program will show you all the rates from the different carriers. It will also compute a saving analysis. To compute the monthly and annual savings analysis we will need some idea of what you are currently paying per minute for each type of service. This part is optional, but if you will provide your current rates then our savings analysis will be more accurate.

    Interstate outbound switched rate $______ Interstate inbound (800) switched rate $______
    Interstate outbound dedicated rate $______ Interstate inbound (800) dedicated rate $______
    Intrastate outbound switched rate $ ______ Intrastate inbound (800) switched rate $ ______
    Intrastate outbound dedicated rate $______ Intrastate inbound (800) dedicated rate $______

    If you have any question please don't hesitate to call 1-800-861-5636