Order Form

What type of phone(s) you would like to rent?
Type of Phone	Additional Information	Quantity
Nextel	One-to-One or Group Direct talk
BlackBerry	Emailing, Messaging, or
Cellular	For use ONLY in U.S.
GSM/International	For use outside the U.S.
Satellite Phone	We are an Authorized dealer for the Iridium satellite phone!
Digital Pager
Megaphone
Two-Way Radio
*NOTE:For more than 10 phones, please ask about our volume discount
Where will you be using the Phone?

*Note: to select multiple countries, hold down the "CTRL" key while making selections
Where Will You be Calling?

*Note: to select multiple countries, hold down the "CTRL" key while making selections
How long will you need to rent the phone?
From:

To:

Contact Information *(Fields marked with an "" are required to complete your request):
Prefix
*First Name
*Last Name
Company
Address
Line 2
City State *Zip/Postal code
Country
*E-mail
*Daytime Number
Evening Number
Fax number
Referral Information
*Referred by
Company Name	(i.e. Which Hotel, Search Engine etc...)
Employee or Person
Referral City State
Agency/Hotel Fax
Delivery Information
Deliver to:	Primary Address Listed Below Will pick up at your office
Delivery Address
Line 2
Delivery City State Zip/Postal Code
Telephone for Delivery Address
Additional Comments:
For your Security, we will take your credit card information when we speak with you over the phone.