Korrect Technology Network Request Form

Your Name    
Your Title
Company Name
What Industry best describe your business?     
Phone     Other
Address    
City     State     Zip    
Email Address    
Website Address
Business Hours Of Operation
Type of network you requesting? Choose Application Computer Workstations Both
Do you have a server in-house? Choose No Yes
What type of Internet connection do you have?
Are you currently on a network? Choose No Yes If yes, describe network.

Are you requesting a new network? Choose No Yes If yes, briefly describe what you want your network to do.


What is the estimated number of computer workstations on your network? 

Special Instruction or comments:


Please note: Our representatives will always attempt to give you the most competitive price possible. Any quote or estimate you receive from us is only valid for 30 days.

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