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Billing Inquiry Form
Sales Form

Sales Form
Thank you for your interest in The Billing Resource: your custom-tailored billing solution provider. For innovative billing solutions, we need your feedback. Please fill out the information below and send us your request or comments.

Note:* indicates required field

Can we help you with the following?*
Select the type of billing you are interested in:* (Check all that apply)
Internet Access Services
Internet Telephony Services
Enhanced Internet Services
Long Distance
Wireless Services
Operator Services
Calling Card
Voicemail
900 Information Services
Other
How did you hear of us?*
How are you currently billing your users?* (Check all that apply)
LEC Billing
Direct Bill
Check Debit
Credit Card
Comments or Questions:
Name:*
Email:*
Job Title:*
Company Name:*
Address:*
City:*
State/Province:*
Country:*
Zip/Postal Code:*
Daytime Telephone:
Fax:
Preferred contact method:* Telephone
Email
Postal Mail
If you prefer to be contacted by phone, please provide the best times we may contact you:
Would you like to be on our mailing list? Yes
No
What is the time frame for making a purchase decision? 0-3 months
4-6 months
7-12 months
13-18 months
Over 18 months
What is your role in the decision making process?* Recommender
Evaluator
Approval

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