Low Rates by DC Network

Signing Up For
Program II

To sign up, please complete the form below and click submit.
All information is required as applicable.

PLEASE ANSWER 1 - 5 USING THE BILLING NAME AND
ADDRESS ON YOUR LOCAL TELEPHONE BILL:

1) Name:

2) Street address (no P.O. Boxes):

3) City:

4) State:

5) Zip Code:

6) Select the name of your local telephone company:

7) If you selected "Other" in #6, enter the name of your local telephone company here:

8) Does your Local Telephone Company list you as a business or a residential account?

9) List the numbers to be registered (put an "M" next to main numbers):

10) Contact person for this account (if different than #1):

11) Email address for the contact person:

12) Do you want an Authorization Code to use the service when you are away from your registered line(s)? (Adds 2¢ per minute to all rates)

13) What monthly limit do you want to set for your calling?

14) If you were referred to this program, please enter the person's name here:

Questions/Comments:

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