Systems Technician Application

First Name*	Last Name*
Address*
City*	State*	Zip*
Phone*	E-mail Address*

Are you already an independent contractor?
Yes
No

How many years of phone system installation experience do you have?

Have you installed structured cabling (low voltage cabling)?
Yes
No

What systems brand(s) do you install or service?

Samsung		Nortel
Avaya		Lucent
Inter-Tel		NEC
Panasonic		Cisco

Other

Have you Installed or supported any of the services below?

PRI Service	Yes No	Integrated T1	Yes No
MPLS	Yes No	DSL	Yes No
Frame Relay	Yes No	POTS	Yes No
Internet T1	Yes No	VoIP	Yes No

Do you have your own tools?
Yes
No

Are you familiar with TCP/IP and basic router setups?
Yes
No

Please indicate if you are able to do:
Low voltage Cabling
Pulling permits in your name
Fiber Installation and Termination

When are you available to start receiving contract work?
Immediately
Within 1 week

Other

DiscountCall is unique in that we compensate our technicians for sales they help generate from existing relationships or new ones they help generate. Are you interested in having DiscountCall service all or a portion of your existing accounts? Unless otherwise noted you would be the technician handling the account but would be relieved of dispatch and collections freeing your time up from non-money making tasks.

Please indicate if you are interested in DiscountCall handling your existing accounts:
Yes
No
Maybe

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