Please ensure that you meet our current criteria for interconnection before completing this form. Thank you!

Note - * indicates a required field

Contact Information

*First Name:
*Last Name:
*Title:
*Company Name:
*Address:

*City:
State:
*Postal Code:
*Country:
(Please include Country and City codes for numbers)
Phone Number:
Fax Number:
*Email:
Primary URL:

Questionnaire

*1.	How did you hear about iBasis, Inc.?
	Ad	Referral
	Association	Speaking Engagement
	Brochure	Tradeshow
	Direct Mail	Web Surfing
	Press Release	News Article
	Currently doing business with iBasis
	Other:

*2.	Are you currently doing Internet Telephony?
	Yes No

	a.	If yes, who are you working with?

*3.	How many minutes of international traffic do you originate a month?
	Less than 100,000	500,000 - 1,000,000
	100,000 - 250,000	Greater than 1 Million
	250,000 - 500,000

*4.	How many minutes of international traffic do you terminate a month?
	Less than 100,000	500,000 - 1,000,000
	100,000 - 250,000	Greater than 1 Million
	250,000 - 500,000

*5.	Please indicate your area of interest:
		Terminate international traffic from the iBasis network in your country.
		Send your international voice or fax traffic over the iBasis network.