Cariaccess Communications
Ltd.
Print this form and fill in the necessary information.Then you can bring it in or fax it to Cariaccess and get signed up immediately.
Application Form
Address:___________________________________________________________
___________________________________________ ID #__________________________
Phone -
work:___________________________
home:________________________________
How did you hear about
us:_______________________________________________________
Please initial the following points to indicate that you
understand and agree to the terms of this offer:
_____ I
agree to abide by the terms and conditions of the Cariaccess Terms of Service.
These
are available on our web site at www.cariaccess.com
_____ If
I choose a timed plan and go over the allotted hours, the system does
not
automatically
shut me off, but will bill me $2.30/hr overtime,
which
I agree to pay when billed.
______ My bill will be emailed to me at
my Cariaccess email address, along with update newsletters
alternate email: _____________________
I choose the following plan: (please circle your choice below)
Service rate:
$___________ per month
/ quarter / prepaid Rates are
Inclusive of VAT
logon and email name:__________________________ @
cariaccess.com
password:____________________________ Dated:______/______/_____
|
for
office use: received on ____/_____/____ entered
by _______ |