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Please leave blank:
Name:
Business Name:
What is your Postcode:
Email:
What is your Telephone Number?
What Broadband do you currently have?
ADSL
ADSL 2+
FTTC 40:10
FTTC 80:20
FTTP
Not sure
Are you currently in contract?
Yes
No
When does your current contract end?
Less than 30 days
Within 3 months
Within 6 months
6 months +
What Broadband product are you interested in?
ADSL2+
FTTC (Fibre to the Cabinet)
SoGEA
FTTP (Fibre to the Premises)
Converged 2+
Converged FTTC
Converged SoGEA
Converged FTTP
Leased Line
How soon do you require the service to be live?
As soon as possible
Within 3 months
Within 6 months
6 months +
How many employees in your business?
1 -5
6 - 10
11 - 20
21 - 50
50+
Do you use Video Conferencing?
Yes
No
What type of Business are you?
Limited/LLP
Local Authority
Partnership
Sole Trader
Start Up
Charity
Send
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