Pre-Sales Request – Insurefin

Name of Organization*

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Physical Address of Organization*

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How long has your company been operating?*

Drag to the right for number of years

What Insurance Application System is in place?*

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Key Executive Name*

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Designation*

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Key Executive Name

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Designation

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Its Short Comings?

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What do you hope to achieve with a new system?*

Business expectations

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Size of Your Organisation*

Estimate number of concurrent users

Distribution Channels*

Number of branches / agent offices

Estimate Budget?

In United States Dollars

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Contact Person*

Fullname

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Email Address

Contact Number*

Office or mobile

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Pre Sales Information Request