Important Sign-Up Information

By pressing the "I Agree" button (found below), you agree to the following:

This sign-up form, when executed, constitutes an Application for Service, and is legally binding as such. There are NO term commitments required. You are free to leave our service at any time without penalty. Under normal circumstances, your long distance service should be switched within 4 business days. Be sure to check your in-state rate before signing up. Please NOTE: Do NOT call your local telephone company and tell them you want TotalCall or Qwest or Sprint as your long distance carrier (UNLESS we direct you to do so)! If you do so, the Open Network Rate of .35 cents per minute will be charged to your local telephone bill. WE will handle the switchover for you (in some cases, we will need your assistance). The same instructions also apply when adding additional phone numbers to your account in the future - call us first!! Availability of this service is subject to Equal Access and our acceptance of customer. Customer Information  Name, Address, and Contact Information  Your Name or Company (as it   appears on local phone bill): Owner/President (if different): Your Work or Day Phone:   E-Mail: (Required) or write "None"   Social Security # (last 4 digits): (Required)  xxx-xx-    Date of Birth: (Required)  Physical Address: (Required) Physical City: State: State: AL AR AZ CA CO CT DC DE FL GA IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Physical Zip: Billing Address: (Required) Billing City: State: State: AL AR AZ CA CO CT DC DE FL GA IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Billing Zip:       Phone Numbers (Please write in the numbers that you would like us to switch):  Main Telephone Number: (Required)        Additional phone numbers to switch at this address:   (a separate application is required for each location)  Phone #2    Phone #3    Phone #4    Phone #5    Phone #6    Phone #7        Additional Information Current Long Distance Carrier:  (Required)   Average Monthly Long Distance Bill:  (Required) How did you hear about TotalCall?  Let me think... Alta Vista Boston Globe Consumer Forum Excite Family Member Friend InfoSeek Los Angeles Times Lycos Magazine Television Ad Yahoo Other Other Search Engine      Do you want a NEW Incoming Toll-Free Number? (Optional)  YES!* Please assign me a NEW Incoming Toll-Free (877/866/855) number & have it ring to:   *There is a $1.00 monthly fee for this optional Toll-Free service.      Do you have an EXISTING Incoming Toll-Free Number? (Optional) "Pin-Type" Toll-Free Number's CANNOT be switched to our service! I have existing* 800/888/877/866/855 number(s) to switch. If you have an existing incoming toll-free number that you would like to switch to our service, you will need to sign our Responsible Organization Form (this is in addition to completing the "Online Sign-Up Form" by pressing the "I Agree" button below).  Fax your completed and signed form to 1-888-810-3200 (FAX).    *There is a $1.00 monthly fee for this optional Toll-Free service.      Calling Card Information (Optional)  There is NO extra charge to have a calling card added to your account. So WHY NOT order one just for emergencies? YES! I would like calling card(s) added to my account - the per minute rate is 9.9¢ (within the 48 States)    Number of Cards:   No. of Cards: 1-9.9/cpm Card      Please carefully consider the question below: (Required)   Would you like us to switch your Intra-Lata (or "local toll") Service? ** No or Yes **Intra-Lata" refers to "short distance calls" made to an "extended" area just outside of your local calling area. Other names for this service are as follows: local long distance, local toll, regional service, zone calling, etc. If you choose Total Call to handle your intra-lata calls, the per-minute rate will be the same as your in-state rate.      Billing Options   Direct Bill (We will bill all charges to the above mailing address)   Credit Card (This option will be offered to you when you receive your first bill in the mail)        Rate Plan   I am signing up for the 3.9¢/min. inter-state rate program ($2.50 fee if usage drops below $20).   I am signing up for the 4.4¢/min. inter-state rate program (NO monthly fees or minimums for customers with 3 or less phone lines).      Special Instructions (Optional) - Please use the area below for any special instructions.           I hereby authorize TotalCall International Inc. to provide long distance services on the phone line(s) listed in this Agreement and to act as my agent in all matters related to providing the services. I am the person authorized to order services on the phone line(s) listed in this Agreement, and I am at least 18 years of age. I understand that there may be a one-time charge by my local phone company to change long distance carriers. I also understand that I can be held responsible for any fraudulent usage. I guarantee to TotalCall the faithful payment, when due, for all charges incurred for services provided together with all pertinent federal, state and local taxes. If payments are not made when due and attempts made by TotalCall to collect such payment are not successful, service is subject to disconnection without notice.