easyVOIP appliocation form

easy-VOIP
21st Century Calling Made Simple

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Open an easy-VOIP Account

( indicates that an entry is required.)

Your Details:

Title
First Name
Last Name
Existing Account Number (if applicable)
Landline contact number
Mobile Number
E-mail
Which country will you be mainly calling FROM?
What will be your main calling DESTINATION?
Internet Access
Please tell us how much you wish to credit to your account
Amount
Currency

Your Credit Card:

We regret that we cannot accept American Express or Diners Club

Name on Card
Type of Card
If applicable, please enter your Maestro Switch / Solo Card Issue Number
Card Number
Country of Issue
Card Security Number:		(the Card Security Number is on the reverse of your card - last three digits)
Start Date ( Maestro/ Switch/Solo only)		/
Expiry Date		/
#Your card's registered address:-
Street
Street 2
City
County/ State
Country
Postal Code

#Please note that if the address given at this section is in the UK or European Community we will assume that VAT should be applied to your calls - unless you inform us otherwise in the "notes" below

# Please confirm how you will usually be accessing our easy-VOIP service - SIP PC to phone software dialler or SIP handsets or an adapter linked to a router/modem combination.

Customer Services on 0844 804 2803 (Option 4) now 9.30am to 5.30pm Monday to Friday - UK time. – applications received outside these hours will continue to be monitored and processed as soon as possible.

NB. On submission of your details you will be forwarded to a confirmation page to check all of the above details.