Thank you for your interest in MicroCorp. You will soon discover why the MicroCorp Channel Partner Program is hands down the BEST IN THE INDUSTRY when it comes to the management of Carrier Services and Telecom Management Software! Please take a moment to complete the following form so that we may better understand your needs. Once received, a MicroCorp representative will get back to you right away.
How did you hear about us? -- Select One -- TAA Fatpipe Magazine IAN Email Blast Phone+ Magazine Phone+ Website Referral Search Engine thedigest.com Other Company: Address: City: State: -- Select State -- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip: Principal Contact: Email: Telephone: Fax: What best describes your firm's primary business? -- Select One -- Telecom Agent Web Developer Recruitment Agent Carrier Telecom Master Agent Reseller Systems Integrator - VAR ISP Interconnect ASP Have you ever been employed by a telecommunictions carrier? Yes No Which carriers have you worked for and when? Carrier Year Employed: Carrier Year Employed: What is your Primary Interest in MicroCorp and how can we best serve your needs?		Do you currently sell and support Telecommunication Products? Yes No How many years have you been in the Telecommunications industry? -- Select One -- Less Than a Year 1 year 2 years 3-5 years 5+ years How much NEW Telecom revenue does your agency generate monthly? -- Select One -- Less than $1,000 $1,000 - $2,000 $2,000 - $3,500 $3,500 - $5,000 More than $5,000 What telecom products are you currently marketing? Long Distance Data Products Local Services ASP Services Do you want to learn more about Insite our Hosted Carrier Services & Equipment Inventory Management Software? Yes No What products are you looking to represent from MicroCorp? Long Distance (business) Wireless Voice Local Resell - UNE-P Co-location Long Distance (consumer) ASP Data Managed Web Hosting CLEC Web Hosting Conference Calling Carrier Wholesale Internet Web Development MPLS Metro Ethernet VOIP SIP Trunking Telecom Inventory Management T.E.M. Wireless Data Satellite Other     Do you currently have any direct agent agreements with any carriers? Yes No Please check all the carriers you have a direct agreement with. ACC Business AireSpring AT&T - the new Birch (Access) CBeyond DeltaCom Embarq Ernest First Communications Global Crossing Hughes Insite Intelliverse Intercall Internap Level 3 Masergy MetTel Miscellaneous Nautilus New Edge Networks Nuvox Paetec PNG Premiere Global Primus Primus Canada Qwest Savvis SmoothStone Sprint Sprint PCS Telecom Recovery TelePacific Time Warner TNCI UCN Verizon (VZT) Verizon Business (VZB) XO Other Do you currently have an agreement in place with another Master Agency? Yes No Which Master Agencies to you currently have agreements with? 1. 2. 3.