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Network Services Assessment Request Form
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Mandatory Fields :
SECTION 1 OF 2
USER INFORMATION
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Full Name:
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Business Name:
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Address:
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City:
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Province:
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Postal Code:
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Telephone Number:
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Fax Number:
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Email Address:
SECTION 2 OF 2
COMPANY INFORMATION
Please describe the nature of your business or business profile:
• Network Services
• Architecture and Design
• Installation and Configuration
• Support and Maintenance
• Consulting
• Web Services
• Website Design
• Website Maintenance
• Website Hosting
• Web Content Management
• Graphic Design
• IT Consulting
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IT Project Management
• Other IT Services
• Virus Cleaning Services
• Database Design and Maintenance
• Custom Programming
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