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AT&T Sign-up

AT&T Sign-up

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Published by Karen Pierce

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Published by: Karen Pierce on Nov 05, 2009
Copyright:Attribution Non-commercial


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Sponsorship FAN Profile for PSMA CONNECT/VHA

E-mail completed form to ross.deuel@att.com - Version September 2009


Request Information
Date Submitted (DD-MM-YY Format) * 09-14-09 Submitter Name * Ross Deuel E-mail * rd0233@att.com Phone * 972-977-0248 Preferred Method of Communication * E-Mail Comments to the Profile Team (Optional) Type of Request to Profile Team * NEW Contract - New FAN FAN Type* GSM Only GSM FAN Assigned by NBO: Contract Type * CCDA r

Membership Information
VHA or Provista Member? PSMA CONNECT/VHA D&B Number (Optional) Federal Tax ID * Foundation Account Information Required Information Missing BCID for at&t Customer Designation ( 6 characters ) Financial Liability Type * Sponsorship Service Type * Sponsorship Service Provisioning * AWS/Partner/Affiliate Only Company Domain Name(s) (i.e. acmeco.com) Required Information Missing Company E-mail Domain Name(s) * An IRU Automation (Premier) profile will be created for this customer to automate verification of employment utilizing the e-mail domain(s). Failure to provide all applicable email domains will result in manual employment verification by a Care or Activation Representative and could also result in reduced custom offer application and discounts. MAC and Discount Information Distribution Level and Method * End User Credit Are service discounts based on attainment? * No

Member Information
Business Address * Business Name Street City, State ZIP Country Required Information Missing

Member Contact Information
(Day to Day HR Manager/Coordinator) Contact Name Address City, State ZIP E-mail Phone Number FAX Authorized Sponsorship Coordinator Same As Day to Day Contact x
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Required Information Missing

Same as Day to Day Contact

Company Decision Maker (Contract Signer) Same As Day to Day Contact x

Same as Day to Day Contact

Initial Premier User Same As Day to Day Contact x

Same as Day to Day Contact

Profile Information
Equipment Payment Options * Required Information Missing Credit Card Wireless Airtime Invoice Airtime Payment Options * Required Information Missing Credit Card Wireless Airtime Invoice Miscellaneous Shipping Carrier * FedEx Global Instructions Offering (Plan) Discount PERCENTAGE only * 24% Equipment Discount PERCENTAGE only * 45% Accessory Discount PERCENTAGE 0% Additional Information Waive Activation / Waive Start of Service? * No

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