| Order
Form |
Name: |
Mailing Address: |
City: |
State / Zip-Postal Code and Country: |
Phone Number: |
Email: |
SS# or Tax ID: |
Date: |
1. Select the package you are
ordering: |
Check off your choice below.
800 - Bill to Credit Card
Includes 1 Extension
Package |
|
Setup
Fee |
Live |
|
$799 |
Recorded |
|
$799 |
This is a one-time setup fee with a $50 per month
maintenance fee per line. No long term monthly contracts
- you may cancel anytime without penalties.
For Multiple Extensions / $125 each additional.
Package |
Price |
Extensions |
Setup
Fee |
Live |
$799
+ $125 |
2 |
$924 |
Live |
$799
+ $250 |
3 |
$1,049 |
Live |
$799 + $375 |
4 |
$1,174 |
Live |
$799 + $500 |
5 |
$1,299 |
This is a one-time setup fee wtih a $70 per month
maintenance fee per line. No long term monthly contracts
- you may cancel anytime without penalties.
900
- Bill to Phone
Live Package - Includes 1 Extension
Package |
|
Setup
Fee |
Live |
|
$799 |
Recorded |
|
$799 |
This is a one-time setup fee with a $50 per month
maintenance fee per line. No long term monthly contracts
- you may cancel anytime without penalties.
|
2. Select the Billing Rate:
|
|
This is the price you'd like to charge callers.
Circle your choice below.
900
- BILL TO PHONE
PER MINUTE |
|
|
|
$1.99 PER MINUTE |
$2.99 PER MINUTE |
$3.99 PER MINUTE |
$4.99 PER MINUTE |
|
|
|
|
FLAT RATE |
|
|
|
$10.00 PER CALL |
$15.00 PER CALL |
$20.00 PER CALL |
$25.00 PER CALL |
$34.95 PER CALL |
|
|
|
800
- BILL TO CREDIT CARD
PER MINUTE |
|
|
|
$.99 PER MINUTE |
$1.99 PER MINUTE |
$2.99 PER MINUTE |
$3.99 PER MINUTE |
$4.99 PER MINUTE |
$5.99 PER MINUTE |
|
|
FLAT RATE |
|
|
|
$10.00 PER CALL |
$15.00 PER CALL |
$20.00 PER CALL |
$25.00 PER CALL |
$30.00 PER CALL |
$35.00 PER CALL |
$50.00 PER CALL |
$75.00 PER CALL |
|
3. Enter the Forwarding number/s: |
| (FOR
LIVE PACKAGE ONLY)
Extension #1 - Forward to this phone number: _________________
(INCLUDED FREE)
Extension #2 - Forward to this phone number: _________________
Extension #3 - Forward to this phone number: _________________
Extension #4 - Forward to this phone number: _________________
Extension #5 - Forward to this phone number: _________________ |
4. Payment Information: |
Total Enclosed: $_____________
Payment Method:
Money Order
Certified / Bank Check
Credit Card
Personal Check (takes 3-5 additional business days to
process)
Credit Card / Debit Card Info:
Visa
Mastercard
Discover
American Express
Full Name:
Billing Address:
Credit Card / Debit Card Number:
Expiration Date:
CVV Number:
(Visa
/ Mastercard / Discover) The 3-digit number in reverse
italicson the back of your credit card.
(American Express) The 4-digit number on the front,
just above your credit card number.
|
| Please make your check or money
order payable to:
FutureQuest Marketing, Inc.
Attn: New Accounts
3003 Yamato Road, Suite C8-1063
Boca Raton, FL 33434
Credit Card Orders May be mailed or Faxed to
(561) 423-9298
Phone Orders/Questions (888) 227-6135
|
| Signature:
___________________________ Date:
_______________
|
