www.teleswitch.com

Company Information (*required field)

Company Name*

Billing Address*

City*		State*		Zip Code*
Country*

Phone*

Fax*

Contact Name*

Phone

E-mail*

Biling Contact

Phone

E-mail

Web URL (if applicable)

The following section is to be completed by the person responsible for administering conferencing for your organization:

In the section “Name”, please list all the people (or departments) who may initiate and host a conference. Each person who may initiate a conference will be assigned a unique ID number for tracking and billing purposes.
If you want multiple accounts created for the same department or ID, please indicate the number of accounts in the “Qty” column.
List the email address for the person responsible for receiving notifications of the usage of the account.
Check the box next to audio and/or web of that user ID can initate audio only, web only or both audio and web conferences.