Thank you for your interest in BX Solutions private label internet services. Please complete the inquiry form below, or you may contact us using the following information.

BX Solutions
2511 W. Shaw
Fresno CA 93711
sales@bx-solutions.com

Phone: 1.866.487.3244
Fax: 559.490.8630

Note: Fields marked with an * are required.
First Name:*
Last Name:*
Title:*
Company/Organization:*
Address Line 1:*
Address Line 2:
City:*
State:*
Zip Code:*
E-mail Address:*
Web Site Address:
Telephone:*
Fax:
I am interested in the following services:*
	Technical support service Dial-up access service
Please answer a few questions about your company.*
What types of internet connectivity do you provide?
	Dial-up Broadband Wireless We do not provide internet connectivity.
What types of customers do you serve?
	Consumers Hospitality industry Other types of businesses
How many subscribers, rooms, or residences do you have for each type of connection?
	Dialup: DSL: Cable: Wireless:
Please describe how services are currently provisioned.
Is your service nationwide or regional?
Are there cities you must have coverage in?  If so, please specify them.
What is your timeframe for switching or starting service?*
Organization Type:*	- - -------------- Select -------------- - - Internet Service Provider CLEC Non-profit Hospitality Other
(If other, please specify)
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How did you hear about us?*	World Wide Web  Referral     By:  Direct Mail  Direct Email  Advertisement