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FREE VOiP Pre-Qualification Form
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* Indicates required question
YOUR NAME
*
Your answer
CURRENT ADDRESS
*
Your answer
DATE OF BIRTH
*
MM
/
DD
/
YYYY
VALID EMAIL ADDRESS
*
Your answer
CONTACT NUMBER (optional)
For immediate communication
Your answer
TYPE OF INTERNET CONNECTION
*
Please select one type of connection you currently use.
DSL (wired connection)
LTE/Broadband/Wimax (wireless connection)
Pocket Wifi/Mobile Data (wireless mobile connection)
Others, please specify. (internet cafe, public wifi, office, etc)
Other:
LIST OF GADGETS
*
Please check one or more gadgets you often use.
Personal Computer (Desktop PC)
Laptop/Notebook PC
Netbook/Tablet PC
Android Phone
Android Tablet
Others, please specify
Other:
Required
ARE YOU INTERESTED TO AVAIL THE SERVICE?
*
Choose
Very much interested, contact me immediately.
Somewhat interested, I need to know more about the service.
Interested, but I don't think it is possible.
Interested, but not this time..
I need to talk to someone first.
I did not understand everything.
Not interested, do not contact me again
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