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Managed Services Order Request Form
Managed Service Option
Responsive
Prescriptive
Proactive
Predictable Care
Name & Address
Initials
Mr.
Ms.
Full Names*
Occupation
[----Select your occupations----]
Administrative Assistant
Business Administrator
Chief Finance Officer
Chief Information Officer
Chief Technical Officer
Finance Adiministrator
IT Manager
IT Officer
Managing Director
System Administrator
Other
If you selected "Other", please specify:
Telephone Number
Email*
Enter a valid email address
Country
[-----Select your Country-----]
Burundi
Kenya
New Sudan
Rwanda
Tanzania
Uganda
Others
Compony/Organisation Information
Name of the Company/Org
Physical Address
Number of PCs
01-05
06-15
16-30
31-50
51 and Above
Number of Servers
01
02
03
04
05
Nature of the Organisation
Which best describes the nature of your company/org?
[--Enter the Nature of Your Compony--]
Casino & Entertainment
Embassy
Government
Hospital
International Organisation
NGO
Private Sector
School
Others
If you selected "Other", please specify:
Enter your message
here
(enquiries, suggestions or comments)
Managed Serivices
Responsive Care
Prescriptive Care
Proactive Care
Predictable Care
