Return
to Main Menu
Callback Service Application for Corporate Accounts
Please print this form and mail or fax all pages of your application to:
Tel. 860-677-6562
Fax: 860-677-7107
Call The World Telecommunication, Inc.
P.O. Box 423
Farmington, CT 06043
Account Information:
| Corporation: | Contact: |
| Address: | Telephone: |
| Fax: | |
| Contact: |
Enter the phone number that the call-back system should call back to, as if dialing from the U.S. Space for five callback numbers is shown below. If more are needed, please list additional numbers as required on a separate sheet.
|
U.S. International Access |
Country Code |
Area/City Code |
Customer Telephone Number |
|
011 |
|||
|
011 |
|||
|
011 |
|||
|
011 |
|||
|
011 |
Please note: after your account is established you will be able to remotely change the number at any time using your authorization code.
Please circle the language you prefer for your voice prompts.
|
English |
German |
Spanish |
French |
Japanese |
Chinese(Mandarin) |
Method of Payment
There are three methods of payment: credit card, purchase order, or prepayment. Please select the method of payment and complete the application below.
1. Purchase Order
Government offices may open an account with CTW and pay upon presentation of an invoice from CTW. An invoice with a complete listing of every call and the cost of each call will be faxed to you at the end of the month. Payment must be made upon receipt of invoice. All payment must be made in US dollars drawn on a US bank. Please attach a purchase order to your application or provide your reference number.
Reference Number or Purchase Order:
| Reference Number or Purchase Order Number: | Date: |
2. Credit Card Payment
Charges will be billed against the credit card once each month for actual usage incurred. A complete listing of the calls made and the charge for each call will be mailed at the end of each month. CTW may obtain a credit card authorization for the estimated usage amount, but will only charge for actual services, after they have been rendered. In the event that the credit card becomes invalid, the customer must provide CTW with a valid credit card number or pay all outstanding debts by check or cash.
|
Credit Card Information: |
|
|
Credit Card Number: |
Expiration Date: |
|
Name on Card: |
Card Issuer: |
3. Prepayment
Checks drawn on US banks are accepted by CTW. If you have a bank account in the U.S., payment can be made by mailing the Callback Service Application along with a check made payable to Call The World Telecommunication, Inc.. You may also wire transfer money. Please contact us for details.
Agreement:
I agree to pay and specifically authorize Call The World Telecommunications, Inc. to charge for long distance telephone service. I agree to pay all outstanding balances owed to the CTW. Disputes must be made in writing, via mail or fax no later than 30 days after receipt of invoice, to CTW Customer Service, Call The World Telecommunication, Inc., P.O. Box 423, Farmington, CT 06043 Tel. 860-677-6562 Fax: 860-677-7107
| Authorized Signature: | Date: |
| Print Name: | Title: |