Lead Registration Form Lead Registration Form This form is used by EPIC Connections to collect information needed to register sales leads. Please fill out the form as completely as possible.Lead Registration Date Date Format: MM slash DD slash YYYY Master Agent Name*Advantage CommunicationsAVANTCarouselFuzeLogMeIn/JivePeakview CommunicationsRingCentralSandler PartnersScansource/IntelisysSimplifyTBITelarusVonageOTHEREnter Master Agent name*Partner Name (First and Last)*Partner Company Name*Partner TitlePartner Phone NumberPartner Email Address* Partner Street AddressPartner CityPartner StatePartner Zip CodeCustomer Contact First and Last Name*Customer Company Name*Customer TitleCustomer Phone Number*Customer Email Address* Customer Street Address*Customer City*Customer State*Customer Zip Code*# of Contact Center Seats*# of EmployeesCurrent Contact Center TechnologyEstimated Close Date Date Format: MM slash DD slash YYYY Service Needed #1Contact Center ConsultingNICE inContact CCaaS ImplementationsProject ManagementAccount ManagementManaged ServicesBPO ServicesOTHER-Please specifyEnter Services NeededService Needed #2Contact Center ConsultingNICE inContact CCaaS ImplementationsProject ManagementAccount ManagementManaged ServicesBPO ServicesService Needed #3Contact Center ConsultingNICE inContact CCaaS ImplementationsProject ManagementAccount ManagementManaged ServicesBPO ServicesDescription of OpportunityFile Upload Drop files here or Please direct any questions regarding this form to Bill Pieper (bpieper@epicconnections.com) or 402-884-4700 x201. Send me a copy of my responses Email address CAPTCHAEmailThis field is for validation purposes and should be left unchanged. Services | Expertise | Resources | Partners | Blog | About | Contact © 2020 EPIC Connections, Inc.