CHANNEL PARTNER INQUIRY FORM If you're interested in being a Global Crossing Master Agent, Branch Agent or Referral Partner, please provide the following information. We'll respond to your query soon. * Required Fields YOUR PROFILE Your Name:*     Business Name:*     Business Address:*   Town/City:*     State/Province:*     Zip/Postal Code:*     Country:*     Phone:*     Email Address:*       Website: YOUR ALTERNATE POINT OF CONTACT (if different): Business Address: Town/City: State/Province: Zip/Postal Code: Country: Phone:   Email Address:   TYPE OF PARTNERSHIP YOU ARE INTERESTED IN (Check One):*   Master Agent - Your own customer-facing sales force and support staff, and the potential to generate a negotiated contract minimum per month in revenue through your team's hard work, supported all the way by Global Crossing's Partner Support Center Branch Agent - You team with Global Crossing's sales and engineering force in your area to generate proposals, manage relationships and close sales Referral Partner - You create interest in Global Crossing through your strong, pre-exisiting relationships, then pass your qualified leads to us and we handle the rest NATURE OF YOUR ENTERPRISE (Check One):*   Individual Business/Organization PRODUCT SET/ SOLUTIONS OFFERED (What type of services are you comfortable recommending?) ATM Dial up and Dedicated Internet Access Frame Relay Switched and Dedicated Long Distance Voice Services Private Lines IP-VPN's Audio and Video Conferencing Services Local Dial Tone Services Your Target Customer Focus: (ie, Vertical/Market Segments, Geographic Coverage Area, Sources of Qualified Leads etc.) Any Partnerships / Alliances / Certifications etc in which you participate or to which you belong?(Optional):   By submitting information to Global Crossing via this website, you accept the terms and conditions of our Privacy Policy (available to view HERE), and you consent to the use and processing of that information by Global Crossing in accordance with that policy.