| *Applicant
Information |
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| *First Name: |
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| *Last Name: |
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| *Salutation: |
Mr.
Mrs.
Ms. |
| *Contact
Number: |
-
- |
| *Billing Address: |
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| *City: |
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| *Province: |
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| *Postal Code: |
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| *Date of Birth: |
- -
(DD/MM/YY) |
| E-mail Address: |
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| Current Long Distance Co.: |
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| Call Country: |
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| Average Monthly Usage: |
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| *Telephone No.
Register for World Access Service |
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| Rate Plan: |
Require Pin
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*Choose Your Billing Option
E-Billing E-mail
Address:
By Post |
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| *Choose Your Payment Method |
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|
Monthly Invoice |
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Credit Card Payment |
 Print
Authorization Form (27KB) |
| *Please
print the payment authorization form, then fax or mail to
us. |
| |
|
Bank Pre-authorized Payment |
Print
Authorization Form (27KB) |
| *Please
print the payment authorization form, then fax or mail to
us. |
If you don't have the software, you cannot open this
file.
Please download free Adobe Acrobat Reader.  |
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| Marketing Survey |
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| How
do you know World-Link? |
|
Sales Agent called |
Sales ID
|
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Referral |
Friend's Phone No.
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-
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Flyer
TV
Newspaper
Word of Mouth
Internet Chatroom
Other
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| *Customer Authorization |
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*
Yes, I fully understand the Dialing Instructions and agree
to World-Link's Terms
and Conditions. I authorize World-Link to charge my credit
card for any outstanding payment that is overdue. I authorize
World-Link to obtain or exchange personal information with
any agent towards establishing or verifying my credit.
World Access Service will be provided to you under the World-Link
Communications Inc. (World-Link) Services Terms
and Conditions and amendments thereto as World-Link may
stipulate from time to time. These Terms
and Conditions cover, for example, World-Link's service
commitments, limitations on liability, your responsibility
for payments and how to pay. For questions, please contact
Customer Service. Please note that acceptance of this order
is subject to credit approval. Terms net 25 days, late charge
1.5% / month. |
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