APPLICATION FOR SERVICE
Credit Card Authorization Form 

Our service fee to set up the answering service for your company is $250.00. In addition, there is a $100.00 set up fee to get started. To initiate service,  complete the application, authorize us on your credit card for $350.00. Return this form via fax  to (703) 995-0899. Please select one of the Service Plans: 

Heavy Volume User Plan   Moderate Volume User Plan   Extremely Heavy User Plan Significant Volume User Plan   302 (Delaware) exchange with call forwarding

                                              DOES HEREBY AUTHORIZE Global Corporate Services, Inc.
        (Name on Credit Card)
to charge the amount of $ 350.00 to its:     

Account No.                                                Expiration Date                          

Credit Card Billing Address                                                                         

City, State, Zip                                                                                           

Telephone No.                                                 Fax No.                                

Email Address                                                                                           

Authorized Signatory:                                      Dated:                                  

Click here to review the plans and rates.  

APPLICATION FOR SERVICE Contact Information

Company Name:                                               eMail Address:                                       

Main Phone #:                                                   Fax #:                                                   

Address:                                                                               

City, State, Zip                                                                               

 Federal ID#:                                           Business Hours:                                                    

# of years in business                                      # of employees:                                        

Authorized Company Contact:                                                  Direct Phone/Ext:                           

APPLICATION FOR SERVICE Billing Information

Address:                                                                       

City, State, Zip                                                                                 

Account Receivable Contact                                            Direct Phone                                           

APPLICATION FOR SERVICE Business References

1) Business Name                                                                        

Contact Person                                                                       Phone Number                                 

2)  Business Name                                                                        

Contact Person                                                                       Phone Number                                 

Banking Information

Bank:                                                                              Acct#:                                                       

Phone:                                                                             Contact Person:                                      

APPLICATION FOR SERVICE Contact List

Name:                                            Primary/Urgent #’s                              email address ____________________ 

Name:                                            Primary/Urgent #’s                              email address ____________________ 

Name:                                            Primary/Urgent #’s                              email address ____________________ 

Name:                                            Primary/Urgent #’s                              email address ____________________ 

Name:                                            Primary/Urgent #’s                              email address ____________________ 

Name:                                            Primary/Urgent #’s                              email address ____________________ 

Products/Services Offered:                                                                                                                               

Answer Phrase:                                                                                                                                                

Message Delivery Preferences:                                                                                                                        

Contact Order:                                                                                                                                                  

Contact Immediately for:                                                                                                                                  

Hold Messages for:                                                                                                                                            

Estimate Call Volume:                                                                                                                                      

Types of Calls You Receive:                                                                                                                             

Always Ask These Questions:                                                                                                                           

1.                                                                                                                                                                      

2                                                                                                                                                                       

3.                                                                                                                                                                      

4.                                                                                                                                                                      

Special Handling of Callers:                                                                                                                             

Additional Information or Special Instructions:                                                                                                

DISCLAIMER:  I  do hereby certify that Global Corporate Services, Inc. has not provided me with personal counsel or tax advice with regard to the services provided.  I understand that the administrative fee reflected above is to initiate Answering Services for my company. I further understand that Global Corporate Services, Inc. is not providing me with the Answering Services and I acknowledge and understand this Answering Service is an independent company and not part of Global Corporate Services, Inc.

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