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Request Information

* Firstname:

* Lastname:

* Address1:

Address2:

* City:

* State:

* Zip:

Country:

Title:

Company Name:

* Phone:

* Email:

Fax:

How did you hear about us:

Level of Attention:

* = Required                        Comments:

Information requested on the following product(s):

 inHANCE Small Business   inHANCE Utility Solutions   Financial Management System

                                                                              

How to send requested information:

  Send Product literature by mail.        Would like a web demo.          Have a salesperson contact me.

                                                                                              

Type of service provided (Metered & non- Metered)

   Electric     Gas      Garbage     Water      Sewer      Other

                                             

Number of customers / meters serviced:

Cycle Billing: Yes   No

                     

Billing Period: Monthly   Quarterly   Other

                                         

Current Billing Software:

Current Financial Software:

Current Hardware: 

Number of Users:

Expected time frame to purchase:

  1 Month    3 Months    6 Months    1 Year or More

                                          

 

Expected time frame for system implementation:

 1 Month    3 Months    6 Months    1 Year or More