Sign Up! (Alpha Dispatch Service -- Automated)

To begin the process of applying for Automated Alpha Paging Dispatch Service, please answer the following questions.

Your attention to detail at this stage will result in much more efficient and effective service. We need specific information regarding your needs and expectations. Complete, well-thought-out answers will help Phonepower^Ž to personalize the service for your specific requirements. Please note that some answers are REQUIRED in order to establish service.

Please route this information to the attention of this Phonepower^Ž Customer Service Specialist:
If your Phonepower^Ž Customer Service Specialist is not listed above, please enter their name here:
Subscriber Name (Company or Person)
Subscriber Contact Person (Owner or Manager)
Physical Address, City, State, ZIP Code	A physical address MUST be provided!
Billing Address, City, State, ZIP Code
E-mail Address of Contact Person
Business Federal Tax ID (EIN) (or Social Security Number for individuals or sole proprietorships)
Main Published Phone Number (including Area Code)
Secondary Phone Number or Toll-Free Number
Private ("inside") Phone Number
FAX Telephone Number
Alpha Device Phone Number	(with Area Code) If devices uses an Email Address, enter that.
Alpha Device Type	Alphanumeric Pager Cell Phone PDA
Alpha Service Provider	Example: ATT, Metrocall, Verizon, PageNet, Cingular
Alpha Service Customer Service Contact Phone Number	(with Area Code)
If your company has a Web Site, please enter the address here:
Type of Business, including Product Line (if applicable). [Please include specific* information identifying your product(s) or service(s). "Sales" or "Marketing" or "Retail" are too general and NOT valid responses.]*

How did you learn about this web site? *(To select more than one option, hold down the <CTRL> or <CMD> key)*
If requested, please explain or provide additional information to your answer(s) to the above question:

Date you would like service to begin

Need a Calendar? Click here.

How will the calls be directed to Phonepower^Ž?

Will you be using a Toll-Free Number?

Yes -- provided by Phonepower^Ž
Yes -- we already have one
Not at this time

What words should we use to answer the phone?
(60 character limit)

Suggestion: "Message Line for __________, Your Name Please?"

Your Time Zone

Time Zone "Other" explained

Please describe what you would consider to be types of "Routine Calls" that we might received on your line.

What types of information are we expected to try to obtain from the caller?

Please remember that this list should be kept to an absolute MINIMUM, in order to control your costs

Caller Name
Company
Phone Number
E-mail Address
Message
Best time to return call
Advise caller to CALL BACK if call is not returned in 15 minutes OR
Advise caller to CALL BACK if call is not returned in 30 minutes
OTHER -- Please SPECIFY:

Please indicate your preference for Email backup

Email Time(s), Email Address, or other Detail:

Which Rate Plan do you consider most appropriate for your needs? (Refer to your Rate Proposal for details)	Base Rate $ (US Dollars)
	Calls Included
	Additional Calls Rate ˘ (US Cents)
Your rate plan CAN be changed at any time if your usage increases or decreases. The minimum period of service is 30 days.

Use this space for additional information NOT included above

IMPORTANT
By initiating or subscribing to and using the services of Phonepower^Ž, you agree to the
TERMS AND CONDITIONS as outlined on the
Service Policies, Supplemental Charges and Terms and Conditions Page.
PLEASE REVIEW THIS INFORMATION before submitting your application,
and click to place a DOT IN THE ACCEPTANCE BUTTON below.

*Please refer to the Terms and Conditions statement or speak with your Communications Consultant
regarding additional charges for these services.

IMPORTANT: Messages for Alpha Dispatch Service
will NOT be retained in Phonepower^Ž files.

Please NOTE that Phonepower^Ž needs the information on this form
prior to commencement of service.
Procedures proposed by Subscriber are SUBJECT TO ACCEPTANCE by Phonepower^Ž

I have read and understand the TERMS AND CONDITIONS
and SERVICE POLICIES.
I understand that by initiating or subscribing to and using the services of Phonepower^Ž, Inc.,
I agree to be bound by these provisions.
I further understand that for service to continue,
I must PRINT OUT, SIGN and MAIL or FAX
a signed copy of this Service Application to the PhonepowerŽ, Inc Office, to be received
not more than TEN DAYS from the date I submit this application on-line.
[Addresses and Fax Numbers are on the Home Page]

If this button is checked, I HAVE NOT read the TERMS AND CONDITIONS
and SERVICE POLICIES,
and will NOT be eligible to begin service.

IMPORTANT: You MUST click on the "Submit Application for Service" button (below) in order to transmit this information

Method of Payment

Credit Card Payment

To pay by credit card, click here to process the payment in a separate window. Once the payment has been processed, RETURN TO THIS PAGE to complete this form.

Check or Money Order

To pay by Check or Money Order, SEND your payment to

Accounts Receivable Department
Phonepower, Inc.
1331 12th Avenue Suite 200
Altoona PA 16601

We are considering taking Check Payments via this form. Although currently unavailable, please check here if you would use that type of payment method in the future.

--- New accounts will be processed once payments have been received. ---

IMPORTANT: You MUST click on the "Submit Application for Service" button (below) in order to transmit this information

SIGNATURE ______________________ Date _
Please PRINT name ___________________________________

Return to Alpha Dispatch Page

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Last modified: December 31, 2005

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