Referred by
Select One
John Thomas
Chris Swatt
Joe Altieri
Fulton County Chamber of Commerce
FultonCountyLife.com
MontgomeryCountyLife.com
Exit27.com
Other
Name
Company
Street Address
City, State and Zip
E-mail Address
Current Cell #
Type of plan/minutes
Who is your current provider?
Residential or Commercial
Select One
Residential
Commercial
Residential and Commercial
Business Phone
Home Phone
How did you hear about Upstate Utilities?
Select One
A Business Associate
Chamber Mixer
Press or Newspaper
Chambers Web Site
Other
Are you a member of the Chamber of Commerce?
Yes
No
Comments:
Upstate Utilities & Consultants, Inc.
Daniel Russo • President & Owner
4720 State Highway 30 • Amsterdam, NY 12010
Tel: 518.842.6130 • Fax: 518.842.6131
E-mail: sales@upstateutilities.com
www.upstateutilities.com
