Home Business Telephone Provider Form

www.HomeBIS.com

Please fill out the form below and submit it to receive more information.

Or, you may complete this form and fax to David Cates at 1-888-393-4500. Additionally you may call David directly at his office at: 1-888-339-9800.

Send details on:

Monthly Long Distance Use:

Monthly 800 Number Incoming Use:

Monthly Calling Card Use:

Monthly Wireless Use:

Name:

Company Name:

Mail Address:

City:

State:

Zip Code:

Phone #1:

Phone #2:

Phone #3:

Fax Number:

Enter -0-, if no Fax.

Email:

Return to Communications Center.

HOME Business Information Service • HomeBIS.com • 362 Keating Street • Green Valley NV • 89014 - 5930

Email: Sharon@Homebis.com • Office: 702 615 4415 • Fax: 702 456 7491 • Membership: 800 575 1994 • © 1996 - 1999

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Send details on:
Monthly Long Distance Use:
Monthly 800 Number Incoming Use:
Monthly Calling Card Use:
Monthly Wireless Use:
Name:
Company Name:
Mail Address:
City:
State:
Zip Code:
Phone #1:
Phone #2:
Phone #3:
Fax Number:	Enter -0-, if no Fax.
Email: