Voice Order Form

* denotes a required field. This form applies to Over-ride and Preselect only.

Customer Details

Company/Customer Name*

Service Installation Address*
(Level, No., Street, City, Postcode)

Telephone Number*
(For contact)

Fax Number

Mobile Number*

Website Address

Service (tick appropriate box)

Service Number(s) (At this site only)	Line Type (ISDN or PSTN)	Over Ride	Preselect	Minimum Monthly Spend
	ISDNPSTN
	ISDNPSTN
	ISDNPSTN
	ISDNPSTN
	ISDNPSTN
	ISDNPSTN

Business Equipment Type and Maintainer

LCR programming required
(If neither, skip the rest of this section)

Long Distance Local

Manufacturer

Type, Model, Software Version

Maintainer - Name and Contact number

Do you have any calling restrictions on any of these lines?

If Pre-selected, I understand that Maxinet will carry my Long Distance, International and Fixed to Mobile calls. I may also nominate Maxinet to carry selected Local Calls (timed after 10 minutes) by using the Over-Ride code. I warrant that I am not contracted to any other provider.

I have read and agree to Maxinet's terms & conditions and voice terms & conditions.

Voice Order Form

In this section: