1-800-865-1115 5245 Harvester Road, Burlington, Ontario, L7L 5L4 
Telecom Banner
 
 

Telecom Computer's agreements with the Tier-1 manufacturers preclude us from selling products to consumers and home based businesses.

Required fields are marked with an asterisk(*)
Corporate Information
Company Name:*  
Address:* City:*
Province/Territory:*
Postal Code:* Fax:
Tel:*
Years in Business:* No. of Locations:*
No. of Employees:*
PST Exempt #: GST Registration #:*
Principal Contact:* Tel:*
Email:*
Type of Business:* DUNS#:
Website Address:*   Telecom Rep:*
Reason for Request:
Contacts  
Accounts Payable:
Tel:
Email:
Purchasing: Tel:
Email:
Other:          Tel:
Email:

Bank Information
Bank Name:   
Address: City:
Province/Territory:
Fax: Years with this Bank:
Tel:
Account Manager:

Business References:
Name: Address:
Tel: Terms
Fax:
Name: Address:
Tel: Terms:
Fax:
Name: Address:
Tel: Terms:
Fax:

THE ABOVE INFORMATION IS TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE
Name:* Date:


 
© 2006 Telecom Computer. All rights reserved.