Date: Thu, 18 Dec 1997 22:36:45 GMT Server: Apache/1.2.0 Last-Modified: Wed, 03 Dec 1997 18:05:37 GMT ETag: "1ca67ae-1682-34859f71" Content-Length: 5762 Accept-Ranges: bytes Connection: close Content-Type: text/html UniDial Communications UniDial Direct Billed Service Agreement
UniDial Direct Billed Service Agreement

Yes! I want to save money on my long distance calls.
Please switch my long distance carrier to UniDial Communications.
Name
(exactly as it appears on
your local telephone bill)
Address (or P.O. Box)
City
State
Zip (or Postal Code)
E-mail address:
Billing Phone Number
Additional Phone Number
Additional Phone Number
Local Telephone Company
Previous Long Distance Company
Please check the appropriate box(es): Interstate
Intrastate
Intralata
International


Yes! I would like a UniDial Calling Card.
Name to Appear On Calling Card
Social Security # (For Security Purposes Only)
Name to Appear On Calling Card
Social Security # (For Security Purposes Only)


I would like to establish a UniDial Internet Services account.
(A one time set-up fee of will be billed to your account)

There is a $.09 a minute charge when using UniDial's nationwide 800# for Unlimited or Variable customers.



E-mail/Username 1st choice (3 To 12 Letters)
E-mail/Username 2nd choice (3 To 12 Letters)
E-mail/Username 3rd choice (3 To 12 Letters)
Password (6 To 8 Letters)
Internet Account
Daytime Phone Number
Evening Phone Number
Fax Number
Mother's Maiden Name
Operating System


(If there is not yet a local dial-up number in your area, you will be registered
for 800# Access. To find out if you are in a local dial-up area, call 1-800-211-9683)



Special Instructions (100 character maximum)