Agent Application


Please tell us about yourself.


NOTE:
All fields should be filled in for an application to be submitted.
If no information is available for a field please type in "N/A".


First name:
Last Name:
Company:
Email:
Area Code:   Phone Number:
Address:
City:
State:
Zip:



Who referred
you or how
did you hear
about us?



If other, please specify


What carriers if any are you directly contracted with?


What carriers if any are you indirectly writing business with?


What is your experience in the telecommunications industry?


How would you describe your role in the telecom channel?
(VAR, Ex-Carrier Rep, Equipment Vendor, Telecom Consultant,
Master Agent, etc.)


What products and services do you sell?
(Voice, Data, Internet, Wireless/Mobility, etc.)


Do you sell equipment and if so who are you certified with?
(Cisco, Avaya, Shoretel, etc)


How many circuits do you sell and/or how much revenue do you generate per month?


How much does your telecom base bill on a monthly basis?


What mobility solutions do you offer?


Why would you like to be an agent with WTG?


Are you interested in offering other utility services to your clients?
(Electricity, Gas, DSM)