Sample Request- Service Providers

Sample Request Form - Service Providers

Fast Track Evaluation Program for Service Providers

Welcome! Service Providers have an exclusive opportunity to request CPE from Comtrend to evaluate for 45 days. This includes Telephone, Cable, and Internet Service Providers currently providing broadband access to residential and/or business customers. DSL units can be pre-configured at no cost based on the information you provide below. Up to three models/units may be sent per evaluation period. Comtrend will call or email for clarification to ensure correct configuration and shipping. By requesting the sample(s), you are agreeing to evaluate the product for your company’s utilization during the 45 day period. Returning or purchasing the CPE is at your discretion. Please contact our sales department with any questions. NA.Sales@comtrend.com

Are you a Distributor?

Service Provider Sample Request Form
1) Contact Information
1) Name*

First NameLast Name
Email*
example@example.com
Phone Number
Please enter a valid phone number.
Company
Title

2) Shipping Information
Recipient's Name*

First NameLast Name
Recipient's Email*
example@example.com
Shipping Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Recipient's Phone Number
Please enter a valid phone number.

3) Source
Preferred Distributor
Other

4) Sample Request - (3 Maximum, otherwise, request exception)
Request Sample(s) Model I*
Notes
Request Sample(s) Model II
Notes
Request Sample(s) Model III
Notes
Additional Notes (Optional)

4)Custom Network Settings Overview
Data
Data
Data Type

BridgePPPoEIPoE/MER (Static IP/DHCP)
Notes
Voice
Voice
Voice Type

BridgePPPoEIPoE/MER (Static IP/DHCP)
Notes
Other
Other
Other Type

BridgePPPoEIPoE/MER (Static IP/DHCP)
Notes
Other Settings
IP Filter
Annext M
ACS (TR-069 Servier)
Other Settings & Requirements
Please verify that you are human*
Should be Empty:

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Sample Request Form - Service Providers

Fast Track Evaluation Program for Service Providers

Are you a Distributor?

Service Provider Sample Request Form

1) Contact Information

2) Shipping Information

3) Source

4) Sample Request - (3 Maximum, otherwise, request exception)

4)Custom Network Settings Overview

Data

Voice

Other

Other Settings

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Comtrend Benefits

Robust Product Offering

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Company