| Name |
|
| Company Name |
|
| Address |
|
| City |
|
| State |
|
| Zip |
|
| Email |
|
| Phone |
ext. |
| Preferred contact |
|
| Business Type |
|
| Number of sites to connect |
|
| Bandwidth |
Note: download bandwidth is 1024 Kbps |
| Equipment needed |
|
| Antenna |
|
| BUC |
|
| Installation |
|
| Do you have emergency power |
|
| Do you currently have a Disaster Recovery Plan |
|
| How often do you lose Telco connectivity |
|
|
