1. Describe the service(s) you would like to order, as well as the city and country (for 6 months or 1 year term):

2. Name to accept mail under:

3. Mail forward frequency (daily, weekly, monthly, etc):

4. Name to forward mail to you:

5. Address:

6. City & Postal Code:

7. Country:

8. Phone (optional):

9. If ordering voice mail/fax line, what email would you like them to go to?

10. If ordering a call forward line, what number do you need calls diverted to?

11. Special Instructions:

12. Payment Method: Check below for your preferred method of remittance: Once
we receive your completed order form we'll email you the remittance details.

Western UnionMoneygramBank Wire TransferSkrill.comPayPal

13. How did you hear about us?

14. E-mail address*:

Please INCLUDE your e-mail address to contact you regarding this order. Thank you