New Customer Intake Form KINETIC VOIP NEW CUSTOMER INTAKE FORM BUSINESS INFORMATION Legal Business Name* DBA/Trade Name Business Type Website Business Address* Federal EIN/Tax ID CONTACT INFORMATION Name* Phone Number* Format: (000) 000-0000. Email* example@example.com Primary Billing Contact Name (if different than above) Billing Phone Number Format: (000) 000-0000. Billing Email example@example.com SERVICE INTENT & USE How will you use VOIP services? Estimated Monthly Call Volume Will you send SMS/MMS? YesNo BUSINESS PHONE NUMBERS Phone Numbers Needed Format: (000) 000-0000. Numbers to Port BACKGROUND INFO Have you worked with us before? YesNo How Did You Hear About Us? ReferralWebsiteSocial MediaOther If referred, please indicate by whom CONSENT & AGREEMENT I hereby confirm that the information supplied is both true and accurate. Signature* Date* /Month /DayYearDate 160 Congress Park Drive Delray Beach, FL 33445 Preview PDF Submit Should be Empty:
