Nextel Sales Information Request Form

Fill out this form if you would like us to provide you with a Quote on purchasing New Nextel Products and Services.

Your Name * First Last
You should be an authorized contact on this account.
Phone # for us to call you on * - (###) - ### ####
This is the phone number we can contact you at between the hours of 8:00am and 6pm. We will not disclose this Phone Number to anyone else.
Are you an Existing Nextel Customer today? * Yes No
Are you an existing Nextel Customer as of today?
If you answered "Yes" - What is your current Nextel Account #?
What Type of Account would this be? * Personal Account Business Account Government Account
Is your phone a personal cell phone (billed to your home address) or is this a Business Cell Phone (billed to your Employers Address) or a Government Account?
Does Your Business or Agency Currently Use Wireless Phones? * Yes No
If You Answered Yes, Who is your current Wireless Provider?

Who is your Current Wireless Phone provider?
Approximately How Many Nextel Phones are you looking for? * 1 - 9 Cell Phones 10 - 24 Cell Phones 25 - 49 Cell Phones 50 - 99 Cell Phones 100 + Cell Phones
This can be an approximation - Gives us a ball park to see if you might be eligible for Monthly Service Discounts from the carriers as well as special equipment rates.
Exact Number of Nextel Phones you need for this Quote?

If you know exactly how many Nextel Phones you need, then list it here.
How Many Cell Phone Minutes will you need MONTHLY per user? Less than 200 Minutes 200 - 500 500 - 1000 Over 1,000 Minutes Per user No Cell Minutes - Just Walkie talkie
Features You Require Monthly Cost is most important Upfront Equipment Cost is most important Cell Phones must be Free - Won't Consider any phone that has a cost I Need International Coverage I Need Local and Regional Coverage Only I Need Nationwide Coverage I Need Walkie Talkie Service I need GPS Service I Need Email Access on this Phone I Need Internet Access on this Phone I Need a Rugged Handset I Need a Smart Phone PDA Type I Need the smallest handset possible Phones will only be used for Emergencies I Need Mobile to Mobile Calling Included I Need Unlimited Text Messaging I Need Unlimited Nights and Weekends
Please check off those features which are most important to you.
Additional Comments
eg: LG Vue or Blackberry Storm
Please describe the phone make and model you would like to upgrade to... tell us what phone you want us to get the best upgrade deal on?
Your Email Address *

Please type your email address here
Business Address - As listed in D&B or Yellow Pages *
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country

Address that Nextel has on file where your bills are sent. This is needed as part of the security check we do to confirm you are who you say you are.
If this is a Company - What is your Web Site URL
Type the letters you see in the image below.