Request For Quote (RFQ) Form

By filling in this form you will be receiving the expert attention and advice of a Internet/Data/Voice Solutions Analyst free of charge. The more detailed information you provide, the better we are able to build appropriate quotes for you by selecting the most suitable cost effective solution and access provider. Using this RFQ system does not require you to make any purchase or set any obligation. The information provided by you will be held as confidential information and will not be disclosed to any potential provider without your prior approval to proceed to the next stage.

All fields are required unless marked as "optional"

 Solution Requirements
Connection Type Please select the type of connection you require. We do not recommend or provide quotes for consumer grade dial-up plans for business use.
Looking to install service When do you want to install or activate this solution?
# of locations The number of locations that need to be connected with this solution.
Country Australia
New Zealand
List locations Please list location addresses and fax or PSTN phone numbers (with prefix):
 Please list locations where connection is required.
Monthly download expected Specify the amount of download you expect per connection per month (in GB)
Connection type used currently What type of Internet connection do you currently use. This will help our market analysts to qualify your RFQ.
 What is your current monthly cost (if you do not have a connection please type 'no access yet')
'optional'		 This will help our market analysts to tailor a plan for your needs and traffic download usage.
 Contact Details
First Name
Last Name Your contact information
Title
Signing authority Yes
No		 Can you authorise this purchase when the time comes?
Email address A valid email address is required to contact you about your RFQ. You will only receive email regarding your RFQ.
Phone number () Please enter the phone number for where the solution is required. This is used by our partners to generate a specific quote and contact you.
Fax number () 'optional'
What will this connection be used for (describe your network environment)
'optional'		 Any special requirements you have or information you think may help our solution analyst.
How did you hear of us Please tell us how you heard about us

For help or to comment on this form email
webmaster@webassist.com.au