Expand Bandwidth Accelerator
Request Form

I would like to…

Purchase
Evaluate
Have a specialist contact me
Have more information forwarded to me

Name

Company Name

Address

City

State

Zip

Phone

Fax

e-mail

Industry:

Manufacturing Healthcare
Distribution Governement

Retail

Education

Other:  

Number of remote locations:

1-5     6-10     11-25     26+

Existing Hosts: (check all that apply)

AS/400 RS/6000 (pSeries)
S/390 NT 4.0 Windows 2000 Server

Linux

Citrix

Other:  

Reason for interest/Applicaton use (check all that apply)

Ensure QoS (Quality of Service) Adding Users
Adding Applications Adding Location(s)
Sluggish Application Performance Other: 

Communication types:

Frame Relay ATM
DSL Satellite

ISDN

Wireless

Communication Speed/s:  (check all that apply)
56K 128K 256K 512K
T1 T3   Other 

I heard about these products from…

Direct mail piece

Trade show/seminar

Display ad in magazine

Yahoo/Web search

Referral

Other

Additonal Comments: