Buddy's Independent Telephone Service

Business Name
Contact Name
Address
Address
City
State
Phone #
e-Mail Address
Fax #

Line Installation
	One Line Phone Jack	Multi Line Phone Jack
	ISDN Line	Dedicated Data Line
	DSL Line

Phone System Purchase & Installation
Number of Lines Needed

Number of Phones Needed

Do you expect to expand your number of phones and lines in the future?

Preferred Phone System Brand


Phone System Programming & Maintenance
Brand/Type of Phone System
Number of Phones
Number of Lines
Please choose one of the following:
	Phone System Maintenance	Phone System Programming

Added Information, Questions or Comments