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1. Describe the service(s) you would like to order, (for 6 months or 1 year term):


2. Name to accept mail under:


3. Mail forward frequency (daily, weekly, monthly, etc):


4. Name to forward mail to you:


5. Address:


6. City & Postal Code:


7. Country:


8. Phone:


9. If ordering voice mail/fax line, what email would you like them to go to?


10. If ordering a call forward line, what number do you need calls diverted to?


11. Special Instructions:


12. Payment Method: Tick below for your preferred method of remittance: Once we receive your completed order form we'll email you the remittance details.


Western Union   Bank Wire   E-gold   E-bullion
   Moneybookers   Web Money

13. How did you hear about us?


14. E-mail address:


Please INCLUDE your e-mail address to contact you regarding this order. Thank you


      

 
 
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