Personal Information Please enter your Name and Address as they appear on your Credit Card Statement: First MI Last Company Address City State Zip Country How may we contact you if necessary? (Day Phone Required for Carrier) Day Hours: How did you find us? Night Hours: ("Yahoo", "Excite",etc.) E-Mail Credit Card Information To split charges across two cards: Card #1 Card #2 Expiration Date: Exp: Amt: Service Options
National AlphaNumeric Pager Rental
1-Year ($40.99/mo)
6-Mos. ($43.50/mo)
$
- Activation: $15.00 - First 100 calls/month FREE, 27¢/call thereafter (charged to your credit card on file)
Additional Per Month AlphaNumeric VoiceMail: Personal 888 $ - VoiceMail Access Code (allows you to access your messages) Choose a 4-number Access Code (don't start with "0"):
OPTIONAL NUMERIC SERVICES
Local Pager Number Choose an Area Code for your Pager's Local phone number: (If you are ordering an 888 or 800 number, please enter "888" or "800" and then select the option in the Optional Services below. The cost is $6.50/month and $5.25/month respectively.)
Numeric VoiceMail Service:
PageMail Plus $
- VoiceMail Access Code (allows you to access your messages)
Choose a 4-number Access Code (don't start with "0"):
Other Numeric Services:
Personal 888 Number $
Common 800 Number w/PIN $
Custom Greeting (no VoiceMail) $
Numeric Retrieval $
- Custom Greeting and/or Numeric Retrieval Access Code
Totals
Pager Rental/Service Total $
Processing Charge $
Subtotal $
2nd Day Delivery $
Overnight Delivery $
Total Charges $