Company:  

Email:           Phone:

Address:   

City:            

State:              Zip:   

Billing Contact:

Billing Email:   

Billing  Phone:

Service Contract: How many Ports: Select one 10 Ports @ $50.00 20 Ports @ $75.00 50 Ports @ $150.00 100 Ports @ $250.00 Other (write below

Comments:

I hereby certify that the above information is true and correct and that A+ Conferencing has my permission to use this information for credit checking purposes.  If credit is extended to me, I agree to pay my invoices promptly within 30 days of the invoice date.  If I default in meeting these conditions, I understand that A+  can place my account on a credit hold status, which means my company cannot use anymore of A+ services until payments are made to restore my account.  And if I do suspect any unauthorized usage, I will report it to Customer Service immediately at 800-622-0190.
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