Dedicated Line Quote Request Form
Point to Point & Frame Relay

Back to Dedicated Connections Page    * Denotes Required Field

First Name:*           Middle:

Last Name:*   

Service Address1:*     

Service Address2:       

City:                    State:*  

Zip Code:*      

Service Area Code:*     Service Phone Number:* Enter numbers only, no dashes ("-").

Company Name:    

E-Mail Address: 

What is your current level of Internet Connectivity: *


How many locations need Internet Connectivity: * 

How many computer users are on your LAN:  *  

Select the connectivity speed(s) you would like quoted: *  
64 Kbs     128Kbs    384Kbs   512Kbs   
768Kbs    T1            T3

Select the contract term(s) you would like quoted: *           
1 Year  2 Year   3 Year  5 Year

Are you considering implementing a Firewall or Virtual Private Network (VPN)?: 

What is your timeframe for implementing/changing Internet Access
to your LAN?: 

What is your monthly budget for Internet connectivity?


 


Email: Webmaster@ChicagoNet.net  Revised: May 1, 2000

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