World Telecom Group - Wireless Quote Request Form

Wireless Quote Request Form

Please fill in as much information that you have.
If you have any questions, please call 310-456-2200 ext 320 or email wireless@wtgcom.com.
You can also FAX any bills, documents, or other information to 310-317-7366.

Enter Agent Information Below

Your Name :
Company :
Agent ID :
Phone # :
Email :

Enter Client Information Below

Client's Name :
Address :
City :
State :
Phone # :
Email :

Current Providers :

Note:
If you are requesting a competitive quote, please send us any recent bills you have to ensure that we can provide the most accurate quote as possible.
For your convenience, they can be uploaded (up to 4) immediately after you have submitted this form, or they can be faxed to (310) 317-7366 or emailed to wireless@wtgcom.com.

Carrier(s) Desired:
Number of Lines Requested:
Number of Pooled Minutes:
How many will need email on PDA or Blackberry Data?
# of Data Cards (if any)?
Expected Close Date? Format: mm/dd/yyyy
Is the client in contract?
How soon does the client want to get services?

Any other requests or needs from the client? Text msg? GPS? International Access? Push to Talk? Unlimited Plans? What devices is the customer interested in?