Channel Partner Lead Submission Form ITS Channel Partner Name* Contact Name* First Phone*Email* Prospect CompanyCustomer Name* First Contact Name* First PhoneEmail* Service they are looking forVoice Solutions# Extensions # DIDs Analog Lines Yes No Toll Free #s Yes No Monthly Budget $ Electronic Fax# Fax #s # Pages/mo Is HiPAA Compliance Required? Yes No Internet AccessSpeed Needed Technology Preference #IPs Required Monthly Budget $ Data SecurityDo they have a Disaster Recovery Solution today? Yes No Do they have a back-up solution today? Yes No Monthly Budget $ Managed IT#Desktops/ Devices #Routers/Switches #Servers Monthly Budget $ Are they receiving quotes from other solutions providers?* Yes No Which providers? Attach copy? Yes No FileAccepted file types: doc, docx, pdf, png, jpg, jpeg, ppt, pptx, Max. file size: 15 MB.Any other information you think would be helpful in closing the sale?CAPTCHAEmailThis field is for validation purposes and should be left unchanged. Δ
