Qwest Direct Awards Application


If you would like to find out more about the Qwest Direct Awards Program, please complete the application below. The information will be kept confidential and does not commit your company to joining the program. A Qwest representative will review your application and contact you within a week.


Organization applicants for the Qwest Direct Awards Program must have access to a minimum of 100 individual members.

* Indicates required fields
 
If you were referred by a Qwest sales representative enter their sales ID:  
 
Organization Information
*Organization Name:
*Head of Organization:
*Federal Tax ID:
URL:
 
*Organization Description:
           Please limit your description to 100 characters.
*Number of Member Businesses:
*Number of Individual Members:
*Years in Operation:
Annual Dues Revenue:
 
Association Address:
*Address Line 1:
Address Line 2:
Address Line 3:
Address Line 4:
*City:
*State/Province:
*Zip/Postal Code:
*Phone:
Fax:
 
Primary Contact Information:
*First Name:
*Last Name:
*Salutation:
*Job Title:
*Email:
 

 
 
 
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