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07/04/2008

Telrite Business Long Distance Signup

To switch your long distance service and start saving money on your long distance calls, please complete the form below, and we will contact you if we need any further information. Thank you for the opportunity to serve you!

To prevent fraud, your computer's IP address has been logged: 38.103.63.16

Required fields are indicated by an asterisk (*)

Main Phone #	* (Numbers only--no dashes, spaces or parentheses)

Company/Organization Name	* (As it appears on your local phone bill)

Main Contact Name	* (As it appears on your local phone bill)

Were you referred by one of our customers? (Leave blank if not)	If you were referred by one of our customers, enter their phone number (with area code), and they'll receive a $5 credit.

Email Address	*
Verify Email Address	*

Physical Address (Where the phone service is located)
Street	*
City	*
State	*
Zip	*

Billing Address (If different from Physical Address)
Street
City
State
Zip

Additional Phone Numbers

Would you also like to sign up for local long distance (intraLATA) service? (Recommended) [Click for more info] *
Yes, I want local long distance (intraLATA) service as well. (This is not local phone service, but long distance service in your area.) No, I only want long distance service outside of my local area (interLATA).

About how much do you spend on Long Distance each month? $ *

Your Birthdate: * (99/99/9999)

Please Enter a Password (6 - 20 characters): *

Please Select a Security Question * (In case you forget your password):

Answer to Your Security Question *

Comments/Additional Information:

Terms & Conditions: I hereby authorize Touchtone Communications to provide long distance services on the phone line(s) listed in this Agreement and to act as my agent in all matters related to providing the services. I am the person authorized to order services on the phone line(s) listed in this Agreement, and I am at least 18 years of age. I understand that there may be a one-time charge by my local phone company to change long distance carriers. I also understand that I can be held responsible for any fraudulent usage. I guarantee to Touchtone the faithful payment, when due, for all charges incurred for services provided together with all pertinent federal, state and local taxes. If payments are not made when due and attempts made by Touchtone to collect such payment are not successful, service is subject to disconnection without notice. It normally takes approximately 7 to 10 working days for your local phone company to complete the switch of long distance carriers. Please do not contact your local telephone company to switch unless you have been instructed to do so by Touchtone, otherwise, you may be subject to paying base rates, also referred to as 'Open Network' rates. If you have provided us with an e-mail address during the sign up process, you will receive further information regarding your account momentarily. I accept all of the above terms *

To begin saving on your long distance bill, just press the "Submit" button below.

Trinity Christian Long Distance^SM is a Service Mark of Trinity Marketing Group, Inc.