Recording
     
* representing compulsory fields



*Company name:
*Contact name:
*EIN or SSN:
*Billing address:
*City, state, ZIP:
Physical address:
City, state, ZIP:
*Phone number:
Fax number:
Mobile number:
Emergency number:
*E-mail address:
Pager number(s):

Service plan Email Fax Live operator Voice mail Order entry
115 min/mo
240 min/mo
490 min/mo
860 min/mo
1,920 min/mo
3,940 min/mo
Voicemail only

Additional plans available upon request

Sign for authorization
I hereby authorize Go4Customer to be my answering service and to act as my agent in all matters relating to answering and messaging services, including ordering telecommunications services related thereto. I agree to the terms and conditions of the Service Agreement attached hereto, and I understand that my use of any service provided by Go4Customer constitutes acceptance of the terms of the Service Agreement. I authorize Answer Force to verify the information given on this application and to receive and exchange credit information concerning this account both now and in the future. Provision of service is contingent upon credit approval.

Print Name:
Signature:
Title:
Date: