Managed Telecom Client On-Boarding Questionnaire

We look forward to working with you to deliver high quality managed telecom services. Please fill out the form below to the best of your ability so that we have information needed to ensure the on-boarding experience meets your needs and expectations.

Legal Business Name

Business Address

DBA, if Applicable

State of Incorporation

Incorporation Date

Tax ID

Primary Point of Contact

First Name

Last Name

Primary Contact Phone

(###)

###

####

Primary Email Address

Site Technical Contact

First Name

Last Name

Site Tech Contact Phone

(###)

###

####

Site Tech Contact Email

Billing

Primary Billing Contact

First Name

Last Name

Billing Contact Phone

(###)

###

####

Billing Contact Email Address

How would you like to be invoiced?

Do you have site-specific billing codes? If so, what are they? (If you prefer to send this to us via email, please send to your account manager.)

Do you have any other special billing requirements?