New Account Setup

Company Information

Company Name  Business Type (select from list)
Street Address  Business Phone Business Fax
       
City  State Zip 
Primary Contact  Phone  Extension
   
Account Owner (if different from contact) Referred by

Seminar Information

Email Address  Password Hint 
for online account management and reporting
Greeting Phrase 
By default the standard greeting is "Thank you for calling {company name} seminars."
Ask for the following information from caller
Would you like to receive daily reports
Date you would like the service to begin calendar

Rates & Fees

Basic monthly charge: $45.00 plus minutes ($0.99 per minute talk rate.)
Calls are measured to the nearest second, ring and hold times are excluded.

Should you decide not to go forward with this account after we have programmed your new account and issued you a toll free number, your credit card will be charged $50 for services rendered (programming account, issuing toll free number, IT services).

Billing Information

Credit Card # Expires On Type
Name on Card 
Billing Address  City  State Zip 

Cancellations must be submitted in writing, and will take effect on the first day of the following month.
The signed agreement must be received via fax or mail prior to the activation of your toll free number.

By submitting this form you agree to all terms and conditions
540 Commercial Street | Manchester | NH | 03101 | 800.888.3188 | ® CALLOGIX 2007