Business Name *

Company Address *

Contact Person *

Phone *

Fax

Email

Web site

Best Time to Contact (HH:MM:SS AM/PM ) *

1. Describe your business needs *

2. Describe your Products or services *

3. What are the primary functions you need a call center to perform ? *
    (Please check all that apply)
   Take sales orders
   Provide customer service
   Provide technical support
   Generate and qualify inbound leads
   Process applications
   Schedule appointments
   Respond to and manage email
   Provide live web chat support
   Provide answering/messaging/services
   other (Please specify) :

4. How many inbound calls, emails, and/or inquires do you expect to outsource on a     monthly basis ? *
   Not sure
   1 to 500
   501 to 2000
   2001 to 5000
   5001 to 10000
   10001 to 20000
   20001 +
   other (Please specify) :

5. When do you want to begin using call center services ? *
   ASAP
   In two weeks
   In one month
   More than two months

6. What type of call center outsourcing coverage do you need ? *
   Dedicated 24-hour coverage
   Normal business hours coverage only
   Normal business hours plus weekend and/or holiday coverage
   other (Please specify) :

7. What is your estimated annual budget for outsourced call center services ? *
   Less than $3,500
   $3501 - 5000
   $5001 - 10000
   $10001 - 20000
   $20001 - 50000
   $50001 - 100000
   $100000 +
   Not sure - Please advise

8. What are the five digits ZIP code for your office location ? *
   

9. What additional call center services would you like provided ? *
   Credit card processing
   Regular reporting
   Web-enabled stations
   Product or direct mail fulfillment
   Script writing
   Foreign language support
   other (Please specify) :

10. Please describe in detail any additional call center requirements ? *