InteliPhone™ Free Trial Order Form
  
 

Thank you for choosing InteliPhone™ service. In order to begin your free trial, you must complete the order form below using valid credit card, billing and contact information. Your service will begin immediately upon approval. At the end of your 7-day trial, if you wish to keep your service active, no action is required. Your charge card will automatically be billed at the end of your free trial, and at the end of each service period, thereafter, in the amount listed for the Package you selected plus Ohio Sales tax, if applicable. If you selected a 'True 800 Number', an additional $15 One Time charge will also be applied at the end of the trial period. If you wish to cancel service at any time, simply contact InteliPhone™ Customer Service at (800) 680-8306 before the expiration of your free trial and your card will not be charged. Note: Only one trial per person per 6 month period. During the free trial period, your account will be limited to a maximum of 30 incoming calls. Emergence Corporation reserves the right to limit this offer for any reason.

 
 
 1. By checking this box, You acknowlege that you have read and agreed to the Terms and Conditions  		 
 
 2. Select an InteliPhone™ VoiceMail Package   		 
 
 3. Choose your Personal InteliPhone Number:

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Member
Merchant Services
 
    a.   866/877/888 Number:    (No Extra Charge)  
    b.   or a True 800 Number:   ($15 One Time Fee)  
 
 4. Enter Billing Information:		  
Learn more about InteliPhone Service
  
   First Name:    Last Name:  Toll Free Customer Service
(800) 680-8306		  
   Credit Card Billing Address:    
   City:     
  State:        
  Zip:    
  InteliPhone Products come with a 30-Day 100% Satisfaction Guarantee  All InteliPhone Services are
backed by a 30-Day
 100% Satisfaction Guarantee
 
  Contact Telephone Number:  () -Your Telephone Number Is Required For This Transaction   
   E-Mail Address:     
   Referred By:  
Last Three Digits in the Signature Line on the Back
Right Four Digits Above Card Number
 
  Card Number:    
(no spaces, no dashes, i.e. 4100111100001111)		  
  CC Expires:       
   CVV2/Card ID:   Refer to the figures to the right for assistance in locating the CVV2/Card ID codes. Refer to the images on the right for assistance in locating your CVV2/CardID.  
   
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We value your privacy and will not share information we obtain about you as you use our products and services.
Review our Privacy Statement

  
 

 5.  Click the Place Order Button on the Right to Complete Your Order   		 
               
 

Copyright© 2004-2008 Emergence Corporation, 5830 Settlers Place,Dublin, OH 43017
All Rights Reserved.