If you would like to find out more about our Agent Program, complete the application below, or contact us at:

Contact details:

Phone: 888-4-VOIPIA, ext 1010
Email: agentprogram@voipia.net

The information will be kept confidential and does not commit your company to joining the program. A Voipia representative will review your application and contact you within a week.

 

*Company Name:

 

 *Website: 

 

* Primary Contact:

  

 * Title:

  

 * Address:

  

 Address 2:

  

* City:

  

 * State:

  

* Zip:

  

* Phone Number:

     (xxx)xxx-xxxx

 *E-mail:

  

 *Business Type:

  

 How many years in Business:

  

 Brief description of your business:

  

Does your firm provide single sourcing for billing to your customers?    

  

Does your firm provide single sourcing for 24x7 Customer Care?

  

 

Staffing - Summarize the resources you currently have

 

Resource 

   Count

Sales Reps

 

 Sub  Agents

 

Sales Support

 

 

Revenue – Please detail your company’s most recent product sales

 

Service 

  % of Total 

Basic Voice Services (B1s, Trunks, Centrex) 

 

Basic Data Services (DSL, Frac T1s)  

 

Complex Circuits (PRI, T1, Frame, Ethernet) 

 

Wireless 

 

VOIP 

 

Other (Specify) 

 

   

 Additional value added services your firm provides customers:

  

Market Focus:

  

 Your primary coverage areas:

 

 

 Customer Focus:

  
   
   

How did you hear about the Voipia Agent Program?

  
 
 

 

 

Copyright © 2004 - 2010 Voipia Networks, Inc. All rights reserved