Personal Office

Sign-Up Form for Local Service

Activity :

New Service with New Number

Transfer Service to Personal Office

Select one of the options to determine how we handle your request.

Type :

Residential
Business

Type of service requested.

Phone :

Enter the telephone number to transfer to Personal Office.

Name :

This is the customer information. Please verify spelling of Name, Last Name and street.

Last :

Address 1 :

Address 2 :

City :

ZIP :

Long Distance Company :

Please enter the Long Distance company if you do not want to use Personal Office as Long Distance provider.

Enter "NONE" if you do not want long distance service.

Installation Date :

Enter the requested date for installation.

Calling Features :

Our lines include all the calling features listed in the description of Local Service. Please enter the modification to the features (if any).

Dealer :

Enter your dealer code

Notes :

Enter any notes that you may help us expedite your request.

By pressing the "Send Order" button on this application I authorize PersonalOffice to act as my (our) agent in all matters relating to providing my local and/or long distance service for the telephone number(s) listed on this form. I understand that this authorization will remain in effect until withdrawn by written notice. If this application is accepted and credit is thereby extended, we agree to pay by the stated due date all charges incurred and billed to me for the local service usage, taxes, fees and any other services contracted for herein or that may be contracted for. I understand I will be liable for all collection fees and past due balances are subject to a 1.5% per month finance charge. I also understand that rates and fees are subject to change. All parties agree that this constitutes a binding contract.