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At Eastlink Business we believe that more options equal more opportunities for your business to succeed. Our range of communication options, including Internet, Telephone, Cable and Bundle services can help your business run more effectively and cost-efficiently. Please complete the form below and an Eastlink Business Solutions Consultant will review the information and develop a solution that best suits your business needs.

Customer Information

Business Name

Contact Name

Position

Contact Number

Email Address

Service Address

Telephone Services Information

What type of telephone service do you currently have, how many lines of each and what are you paying per line:

Type	Lines	Cost per Line
Centrex (feature-rich business service)
Analog Lines (fax, VISA, Interac)
Multi-Line feeding a PBX or key system
ISDN trunks (PRI or BRI)
DS1 trunks
IP
Other:

Who is your current local service provider?

Are any new telephone lines, in addition to your existing lines, required? How many?

What telephone features do you currently have and how much do you pay for them?

Long Distance Services

Who is your current long distance provider?

Would you like for us to quote on your long distance service? YesNo

What is your current long distance rate for:

Atlantic

Canada

United States

Do you make more International calls to any particular country? If so what country(s) and what is (are) your current rate(s)?

Do you require calling cards? YesNo

If yes, how many?

Do you have toll free service? YesNo

If yes, what are your rates? Same as direct dial
Other

If not the same as direct dial, please specify rate?

Internet Services

What type of Internet service do you currently have?

Who is your current provider?

How many computers currently have Internet access?

How many computers would you like to have Internet access for?

How many computers are in your office?

If more than one computer requires Internet access, are they networked? YesNo

If your computers are networked, please indicate type.

Do you require static or dynamic IP addresses? Static
Dynamic

Do you require internet security services? YesNo

Do you find your service fast enough for your needs? YesNo

What are you currently paying per month for service?