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Name
Company Name
Telephone
Email Address
Post Code
2. Equipment Reqirements
Type of network required		Cat5e Cat6e Fibre Wireless Laserbit
Cabinet Required?		---Select--- Wallmounted Free Standing Server Cabinet
Power to Cabinet		---Select--- Yes No Not Known
Patch Leads required (Enter Quantity)		0.5 Metre 1 Metre 2 Metre 3 Metre 5 Metre 10 Metre
3. Network Requirements
Comments		Enter your Comments Here
Project Time Scale		---Select--- Less than 1 week 1-2 Weeks 2-4 Weeks 1-2 Months 2-6 Months 6 Months + Unknown
Does your building have any of the following?		Raised flooring?   ---Select--- Yes No Not Known       Dedicated server/comms room?   ---Select--- Yes No Not Known       High ceilings?   ---Select--- Yes No Not Known
Will building be occupied during installation work?:		---Select--- Yes No Not Known
When will required work need to be carried out?:		---Select--- Office Hours -( 9.00-5.30) Evenings/Weekends Do not mind
How is your building best described?:		---Select--- Purpose Built Commercial Purpose Built Industrial Converted Residential Residential Listed
Which best describes location of required network:		---Select--- Single Room Multiple Rooms - Single Building Multiple Rooms - Multiple Buildings Multiple Sites
Number of data points required:		Singles    Duals    Triples    Quads
Number of voice points required:		Singles    Duals    Triples    Quads
Specify approx length of cable runs in metres:		metres - Long cable run metres - Short cable run
Would you like us to supply an internet connection?:		---Select--- Yes No
4. Next Steps
How would you like to proceed with your request?:		Request a quotation  Request a site survey  Proceed with installation
How and when would you like to be contacted?		Phone Email
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