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Global Crossing Business Advantage Partner Program Application
Please provide the following information. We'll respond to your query soon.
* All Fields Are Required
First Name *
Last Name *
Company *
Address *
City *
State *
Email Address *
Please Confirm Your Email Address *
Phone Number *
Web Address *
Business Model (Choose One)
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If Other, What Business Model?
Years In Business(Choose One)
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Total Employees *
What type of agent relationship are you interested in with Global Crossing? (Choose One)
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Do you manage sub-agents? (Choose One)
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If yes, how many sub-agents do you manage?
Do you currently have a contract with a Master Agent? (Choose One)
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If yes, with what Master Agent?
Total Monthly Billings (Choose One)
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Total Average Monthly Sales (Choose One)
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Please list any carriers you are currently representing.
Please list any certifications.
Where did you learn about the Global Crossing Business Advantage Partner Program? (Choose One)
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