PRIMUS SME Voice Services Order Form

Get PRIMUS SME Voice Services

Use this form to order PRIMUS SME Voice Services.

Please fill out all the information requested below

Primary Location

Company Name:

Address 1:

Address 2:

City

State:

ZIP:

Contact Email:

Contact Phone:

Billing Information

Click here if same as Primary Location

Company Name:

Address 1:

Address 2:

City

State:

ZIP:

Contact Email:

Contact Phone:

Service Information

What type of service do you wish to order?

Direct Dial:

Toll-Free:

Calling Card:

Direct Dial Service

Change all ANIs to Primus?

Yes:
No:

Who is your local exchange carrier?

Billing Telephone Nunmber

Additional Telephone Number

- -

Additional Telephone Number

- -

Additional Telephone Number

- -

Additional Telephone Number

- -

Additional Telephone Number

- -

Additional Telephone Number

- -

Calling Cards

Quantity:

Names (please put each name on a seperate line):

Domestic Toll-Free Service

Number:

New:
Existing:

Terminating number:

Area Of Service
48
50
Canada
VI-PR
Int'l

Number:

New:
Existing:

Terminating number:

Area Of Service
48
50
Canada
VI-PR
Int'l

Number:

New:
Existing:

Terminating number:

Area Of Service
48
50
Canada
VI-PR
Int'l

Tems and Conditions

Please review the Terms and Conditions associated with your product selection:

PRIMUS Terms and Conditions

I accept the Terms and Conditions
I authorize PRIMUS to provide new service or to act as my agent to switch my company's current service.

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