ARC Computers - Corporate Customers Application Form

Corporate Customers Application Form

Below is a list of questions that need to be completed before you are automatically issued a password.
When you have completed the form, click the Submit button to complete your application.

1. Client details

Salutation:
Your Firstname:*
Your Surname:*
Email:*
Contact Phone:*

2. Company Details

Company Name:*
Choose: *
Address 1:*
Address 2:
Suburb:*
State* / Postcode*:	/
Company Phone:*
Company Fax:*
Nature of business:*

3. Required Services

Check the items that apply you or your organisation

We are looking at purchasing computer systems in the near future
We will be, or currently are setting up a network
We are looking at updating / renewing our IT equipment
We are looking at signing or moving our IT maintenance contract to ARC
Specify other:

4. Preferred username

Preferred Username:*	eg. acompanyname

5. Submit your application