Application	Remote Monitoring Telematics Fleet Management Metering Telehealth Security Point-of-Sale Fixed Wireless Terminal  Consumer Electronics Other	What is the type  of your application?
Product Description		Please provide description of your product.
Technology	GPRS   1XRTT   EDGE    UMTS    EVDO HSDPA 3.6 HSDPA 7.2 HSDPA 14.4 HSPA+21   DC-HSPA+ LTE Other	What radio technologies does your product support?.
Freqeuncy Bands	2G Bands  3G Bands  4G Bands	Please list the applicable frequency bands supported by your product.
Module Info	Does your product use an integrated module? Yes No If 'Yes' on above, Manufacturer                                   Model
Region	North America   South America Europe Asia-Pacific Africa	Which region(s) would be launching your product?
Country List		Which countries would you be launching your product?
Operator List		Do you have any preferred operator list?
Airtime for devices/month	1-1000 1001-10,000 10,001 - 50,000 > 50,000	For how many units do you need airtime in a month?
Data Use per device/per month	0-500 KB 501 KB - 1 MB  1 MB - 5 MB 5 MB - 10 MB > 10MB
Timeframe	0-3 months  3-6 months > 6 months	When do you expect to launch your product?
Notes
Contact Details	Name        Email         Phone         Company    City