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Brix Assured Program Application

Thank you for your interest in becoming a member of EXFO Service Assurance's (formerly Brix Networks') Brix Assured Program. Please complete the brief application form below and hit the "Continue" button at the bottom when finished. An EXFO representative will then contact you shortly to discuss your requirements and next steps.

If you have any questions regarding the Brix Assured Program, please send an e-mail message to bap@brixnet.com.

• Indicates field is required
• First Name
 • Last Name
• E-mail
 • Title
• Company
    
• Address
   Address 2
• City
 • State
• Postal Code
 • Country
• Phone
   Fax
• Password
• Confirm Password
• I am interested in monitoring the following services (please check all that apply):
If "Other" please specify
• I am interested in performance monitoring using (please check all that apply):
• Please briefly describe your need (100 words or less):
• Please briefly describe your network elements/devices (100 words or less):
  Please add any other comments here:
     
EXFO Service Assurance | 285 Mill Road | Chelmsford, MA 01824 U.S.A. | 978-367-5600 tel | 978-367-5700 fax | 1-888-BRIXNET