VGC

 VGC Callback Application


Start using callback today, fill out this form and submit it and your call back will be up within 24 hours




Name:    
E-Mail: 
Street: 
City:     State: 
Country:  Postal or ZIP Code: 


Message/Remarks: 


What will be your callback number
(1) 
(2) 
(3) 
(4) 

What Countries will you call from?
(1) 
(2) 
(3) 

What Countries will you primarily call to?
(1) 
(2) 
(3) 
(4) 
(5) 

Authorization: I/We, by signing below, do hereby authorize VGC - Virtual Global Communications, Inc. or its suppliers, Inc., to charge the above numbered credit card $ , which represents a prepayment of one month’s estimated Callback usage. VGC - Virtual Global Communications, Inc. or its suppliers will track and deduct all chargeable calls and account charge of $10/month from the monthly prepayment until 70% of the prepayment is utilized (30% remains), at which time VGC - Virtual Global Communications, Inc. or its suppliers is again authorized to charge the above mentioned card in the amount necessary to reinstate the estimated monthly Callback prepayment. This authorization cycle is to remain in effect until VGC - Virtual Global Communications, Inc. receives written authority from the undersigned to cancel this authority. I am personally responsible for any charges which are not covered by this authorization. I hereby state that all information provided in this application is true and complete and is provided to obtain International Telephone Service from Virtual Global Communications, Inc. or its suppliers. I further affirm that I am authorized to execute this agreement. I accept that it is my responsibility to keep Access and PIN Numbers confidential, to promptly inform Virtual Global Communications, Inc. or its suppliers any changes in the above information, and to pay for all calls billed. Further by signing this services the undersigned states that Virtual Global Communications, Inc. or its suppliers will not be held liable in any way for loss that may result from loss or interruption in services.  This authorization cycle is to remain in effect until receives written authority from you to cancel this authority.  I am personally responsible for any charges which are not covered by this authorization

Signature: _________________________________ Date: _______________

Credit Card: 
Card number:   Expiration Date: 
Issuing Bank:  Telefon:

Preferred language:

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Version 1.1 - Copyrights © 1996 by EDIideas, INC. - Last updated: March 1996

Keywords: long distance, international callback, international private lines, dedicated, switched, interstate, intrastate, international calling, savings