16¢/Minute ATCARDSM Application
ATCARD requires a signature on your application. This form is not meant to be transmitted back electronically. Please print this page now and mail or fax back. You will receive your ATCARD in 2-3 weeks!


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NAME
 
ADDRESS
 
CITY
 
STATEZIP
DAY PHONE
(        )
EVENING PHONE
(        )
NAME APPEARING ON ATCARD
 
[ ]VISA      [ ]MC
[ ]Discover [ ]AMEX
CREDIT CARD #
 
EXPIRATION DATE
SOCIAL SECURITY # OR FEDERAL TAX ID #
 
CHECK FOR CORPORATE CARD
[  ]
I authorize ATCALL to conduct a routine credit check in connection with my application for service. ATCALL may use any information obtainable throughout this credit application or any credit reporting agencies. I understand that such information will be held strictly confidential and will remain ATCALL property. I understand that each month I will receive in the mail a fully detailed calling card invoice listing all the calls and charges. I authorize my credit card account listed above to be charged for the amount due if not paid by due date. Service for the ATCARD shall be subject to ATCALL's tariffs, as may be amended from time to time.
CREDIT CARD AND AGREEMENT SIGNATURE
 
AGENT NO.
269 - M. Simons
DATE OF ORDER

Return to: ATCALL, Inc., c/o Probe Consultants, 262 Eastgate Drive, Suite 391, Aiken, SC 29803-7698.
FAX (803) 652-1727 (Fax is not dedicated; you must call ahead to obtain approval to send a fax.)


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Probe Consultants
262 Eastgate Drive, Suite 391  Aiken, SC 29803-7698
(803) 652-1727

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