ONLINE LONG DISTANCE ORDER FORM
PERSONAL INFORMATION
REFERRED BY:
SAL:
FIRST NAME:
LAST NAME:
ADDRESS:
CITY:
PROVINCE:
POSTAL:
HOME PHONE:
WORK PHONE:
FAX:
EMAIL:
EUROTEL CAN SEND YOUR INVOICE IN YOUR LANGUAGE OF CHOICE (PLEASE COMPLETE THE ARE BELOW):
ETHNICITY:
INVOICE LANGUAGE:
COUNTRIES MOST CALLED:
ESTIMATED LONG DISTANCE/MONTH: $
LINE DETAILS
MAIN LINE NUMBER TO SWITCH:
ADDITIONAL LINES TO SWITCH:
DO YOU WANT TO SWITCH YOUR LONG DISTANCE?:
Yes
No
IF YES, WHICH PLAN:
None
Eurotel Europe
DO YOU WANT TO REFER FRIENDS AND EARN CASH?:
Yes
No
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Tel: (416) 367-3876 Fax: (416) 367-8350
