Company Name_______________________________________________________

Billing Address________________________________________________________

City______________________________________           State_____ Zip __________

Phone____________________ Fax___________            E-Mail __________________ 

Service Contact_______________________           Phone ______________________

Billing Contact________________________           Phone ______________________

Moderator (s) _________________________________________________________

TERMS AND CONDITIONS 

I hereby certify that the above information is true and correct and that CheapConferenceCalls.com has my permission to use this information for credit checking purposes. If credit is extended to me, I agree to pay my invoices promptly within 30 days of the invoice date. Payment by credit card is also acceptable (Visa/MC/Discover); just call Customer Service at 1-888-816-1104 and provide your credit card info.

If I default in meeting these conditions, I understand that CheapConferenceCalls.com can place my account on a credit hold status, which means my company cannot use any more CheapConferenceCalls.com  services until payments are made to restore my account. 

I also agree to guard my pin codes and keep them confidential to prevent any unauthorized usage on my account. And if I do suspect any unauthorized usage, I will report it to Customer Service immediately at
1-888-816-1104.


SIGNATURE___________________________                 COMPANY ______________________

TITLE_________________________________                DATE __________________________

CheapConferenceCalls.com
SIGNATURE____________________________                DATE __________________________