QL Publisher Application

Quantum Leads Publisher Application

Legal Company Name *

Physical Address *

Mailing Address *

Representative First Name *

Representative Last Name *

Representative Phone *

Representative Email *

Representative Skype ID (if applicable)

Accounting Email *

Company Website *

Your business location is not your call center location, but the location your business is registered in. After approval QL will send you either a W-9 or W-8BEN Tax Form to verify your identity. The response below will determine which form we send.

Business Location *

Onshore

Nearshore (Mexico, Canada, and English European countries only)

Offshore

Average Raw Calls (Daily) *

EIN (If Applicable)

Average Billable/Qualified Calls (Daily) *

Active Verticals *

Please confirm that all information is correct before submitting.

By submitting this form you agree to let Quantum Leads contact you via email and/or phone about any opportunities, further system requirements, and/or any other reason. We will never sell your information or send any kind of spam mail.

I understand and agree to the conditions listed above *

Yes

Thanks so much for taking the time to complete this survey! Click submit and an administrator will review and moderate your application. We are looking forward to working with you! 🥳 ⭐️ 🚀