godove.com. Close Window . Plan A, 3000 minute Local Access, 3-way sign-up form
Fill out this form, then print it out, sign and date it, and FAX a copy to the FAX phone number listed at the bottom. Please note, your information is not being sent via the Internet and is perfectly safe.
= indicates a required field
Agent ID Number: A120 .
Company / Individual's Name: ..
CONTACT NAME (if different from above):
 ..
Billing Address (must be EXACTLY as listed on your credit card statement):
 ..
BILLING ADDRESS LINE 2:
 ..
City:
 ..
State:
 ..Zip:..
Phone Number (include area code): .. Extension (if any)..
E-mail Address: ..
Enter the total number of phone lines to be serviced:.
: X 3000 minutes, Basic ( $49.95 per month for each outgoing line).
Telephone Line(s) to be serviced (include area code):.
:  :  :.
Attach a list of any additional phone lines to be serviced.
Credit Card Payment Details:.
I,, authorize DCI to automatically bill me monthly for this service using my credit card information listed below. In addition to the information on this page, I have verified that I am a Local Access customer, and have read and agree to the Terms of Service.
Name on Credit Card:. ..
Card Type: .. (PLEASE CHOOSE YOUR CARD TYPE BEFORE PRINTING)
Card Number:. ..
Expiration Date (Month/Year): ..
Sub Total : (Call Lines) $ ($49.95 TOTAL MONTHLY CHARGE PER PHONE LINE)
$10.00 per line Activation Fee : $ (ONE TIME ACTIVATION FEE OF $10.00 FOR EACH LINE)
Total Charge : $ (TOTAL CHARGED TO YOUR CREDIT CARD FOR THE FIRST MONTH.)
Your Signature indicates that you have read and agree to the terms of use of flatrate products.: _______________________________________________ Date:______________ .
Is all information above correct? To print out this form, set all of your printer's page margins at 0.5 inches (i.e. one-half inch).

Fax Completed Applications to: (973) 770-1566... Once Faxed - You MUST Mail Original To:
Dove Communications, Inc. 132 Landing Rd., Landing. NJ 07850
(973) 770-6570 Fax (973) 770-1566
NOTE: Your credit statement will show Dove Communications, Inc. as merchant account.
Form Revised On - 7/29/03