| |
|
Name: |
|
| E-mail: |
|
| Company: |
|
| Street Address: |
|
| City, State, Zip: |
,
|
| Phone: |
|
| Fax: |
|
| |
|
|
|
| S
E
R
V
I
C
E
S |
|
Number of Phones Needed: |
|
| Choose a Plan |
|
| |
Optional - $2 set up fee for a local US number to ring on your Israeli cell phone. There is a charge of $.25 per minute for all incoming calls to this number. |
| Dates Requested: |
from:
to:
|
| |
Please indicate the date that you will be traveling, and we will assure that the delivery will arrive before that date.
If you need to extend your contract while in Israel, please call or email our customer support and we will be happy to assist you. |
| |
Delivery Request: |
Yes
No (additional
fees apply) |
| |
If Yes,
Delivery Location |
Is this a business address
or a home address?
Delivery to a business address is more secure and will enable quicker delivery.
|
| |
If No, please choose where you would like to pick up the phone |
|
| |
|
|
|
| P
A
Y
M
E
N
T |
|
Payment Type: |
MasterCard
Visa
American Express |
| Credit Card number: |
exp:
mm/yy |
| |
3 digit security code (can be
found on the back of your credit card)
|
| Cardholders Name: |
|
| |
|
|
|
| C
O
M
M
E
N
T |
|
Comments: |
If you are part of a group signing up with Cell Talk please indicate groups name
|
|
I agree to the terms
and conditions set forth by Cell Talk, Inc. and I hereby authorize Cell Talk to charge my credit card for any charges related to this rental.
After submitting your request you will get an automated confirmation via email that we received your request. You will receive an email from us about 1 week before your trip with your phone number and more information. |
|
