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Embarc Customer Sales Entry Form

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Embarc Customer Sales Entry Form

PostedOctober 17, 2024

UpdatedOctober 17, 2024

BySean Hammons

Order Number *0 / 150

Date *

Create Date

Salesperson First Name *

Salesperson Last Name *

Customer Name *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code

Customer Phone *

Customer Email Address *

Desired Installation Date

ISP *FidiumBrightspeedFrontierWindstreamGoNetSpeedBluepeakSonicTDS TelecomMercury BroadbandVerizonRise BroadbandQuantumMetroNetTruVistaService Provider

Speed *100M200M300M500M940M1G2G5G7G10GEnter the speed sold

TV/Phone/Value added service *YesNo

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