Instant InfoSystems Information Request Form

Company*

Name*

Telephone*

ext.

E-mail*

Address*

Address 2

City*

State*

Zip*

Fax*

Approximate number of PC’s*

Approximate number of Fax Machines*

Industry*

Other Industry

How many Fax/eDocument pages do you send daily?

How many Fax/eDocument pages do you receive daily?

How many locations will need supporting?

Email Applications

Host System

Other Host System

What other applications are you using or planning to use in the future?

Tell us more about your needs

* Required fields

Instant InfoSystems
2301 W. 190th St. Torrance, CA 90504
Phone: 310.750.7200 Fax: 310.750.7210
info@instantinfo.com