Faxform TalkTo.Net

We might consider SET orders for yearly payments at a later stage, but decided to stick with Fax orders for the moment.

Choose one :

create new newsgroup  
change existing newsgroup  
extend subscription  

Complete the following table :

existing or new newsgroup name  
password  
type (NNTP or HTTP)  
company  
first name, name  
street  
ZIP city  
country  
fax number  
person in charge  
administrator  
email  
payment period (monthly or yearly)  
subscription (Y/N)
Yes : service is automatically extended until canceled
No : towards the end of the paid period you will be notified
 
wish to appear in directory (Y/N)  

notes

 

 

 

 

 

how to pay

amount to be paid                          CHF

Choose one

bill me at above address (swiss customers only)  
VISA  
EC/MC  

In case of credit card payment :

Name of cardholder  
Expiry date  
Card number  
CVV2 Code new  

The CVV2 Code was recently introduced for additional security. They are the last 3 digits of a number to be found on the signature field of the card and they are separated by a space.

The VAT of 7.6% will be added for swiss customers

 

signature




print this form and fax to : ++41 1 937 15 41

download this form as pdf, and fax it completed to the above number