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**Required Fields
Name
**
Company
**
Billing Address
**
City
** State
** Zipcode
Phone
** Fax
E-Mail
**
What is the Best Way to Reach You?
Phone
Fax
E-Mail **
What is the Best Time to Reach You?
**
How did you hear about EARTEL?
**
Financing Options
Company Check
Finance
If you need to arrange payment options **
Prefer
New or Refurbished
New
Refurbished **
System Desired
Nortel Option 11C-81C
Nortel Norstar System **
Do you need Eartel to install the system for you?
Yes
No **
How many Lines do you need right now?
**
How many Lines do you need for FAX machines or MODEMs
right now?
**
How many additional Lines will you need later
**
How many Workstations do you need now?
**
Of the workstations you need, how many do you need
to be a Receptionist with all lines?
**
Will you need the Busy Lamp Feature option on the
Receptionist workstations? How many?
**
Number of Ports you will need?
**
Would you like to have Voice Mail?
Yes
No **
Would you like to have Music On Hold?
Yes
No **
Do you have any existing system that you would like
to Sell?
Yes
No **
Do you have an existing System that you would like
to Upgrade?
Yes
No **
Please Supply Manufacturer and Model Part Number:
**
Do you have any existing system that you would like
to Sell?
Yes
No **
Please supply Manufacturer, Model Part Number, Color,
Condition:
Do you need to have your telecommunications intergrated
with you computer networks?
Yes
No
Do you need to have your voice mail intergrated with
your eMail?
Yes
No
Do you need a digital phone line connection?
T1
ISDN
xDSL
Frame Relay
Do you need an Internet connection
Yes
No
If you have additional requirements for your telecommunications
system that we did not cover in the form, please do
so:
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