Velocity Telephone

T-1 Lead Generator

Business Name:
Address 1:
Address 2:
City:
State:
Zip Code:

Contact Name:
Contact Phone Number:
Contact E-mail Address:

Please answer the following questions in the appropriate fields below
1.) Who is your current Phone, Internet and/or Data provider? Please enter Company name/s:

2.) Do you have T-1 Service now?
2a.) If Yes, what type of T-1 do you currently have?
2b.) If No, how many phone lines do you currently have?
3.) Do you have a current contract?
3a.) If yes, when does the contract expire (enter date):
4.) What do you currently have for High Speed Internet Access?
5.) Approximately what do you currently pay for all of their services (phone/internet/data) Please fax a copy of your current bills to 763-444-2541.
6.) Are you aware that many phone companies charge additional fees and surcharges that inflate the actual costs of their services by 10 - 30 %
7.) Does you have a need for Wireless or Mobile Internet Access?
Please specify below any additional information you would like us to know below: