License Service Agreement / Terms of Use Account Set Up

Credit Card Payment Form | Other Payment

Organization
Name:
ACCOUNT NAME or ADMINISTRATOR:
* Required
*First Name:
*Last Name:
*Address 1:
Address 2:
*City:
*State/
Providence
*Zip Code:
(P.C)
*Country:
USA Canada
*Time Zone:  
Eastern Central Mountain
Pacific Atlantic  Alaska
Hawaii
* 10 Digit Phone*:
* 10 Digit Cell:
10 Digit Fax:
*Email:
USA: Tax Exempt:
No
Yes**
Purchase Order #:

* Leagues and Larger Organizations – This phone number should be the main 10 digit phone number of your organization, or League Administrator, and will show on the Caller ID. Do not use a number with Call Block. In some markets the name will also appear.

* Non Leagues will be assigned 111-111-1111; this number will appear in the Caller ID   

**Please Mail Exempt Certificate 
Reseller Agency Information:
Agency :
Key #:
Sales Person:

Contract Dates:
* Start Date: End Date:
# of People to Call:
Plans
* I am interested in:
BRONZE GOLD PLATINUM
Teams/Leagues Monthly Plan:
Up to 4 Month Up to 6 Month Up to 12 Month
* Adding Caller ID:
YES NO
Use Phone Number:

Tournment Plan:
1 Day 2-3 Day 4-7 Day

* I Accept the Terms as set forth in this License Service Agreement Terms of Use. Terms
Credit Card Payment:
*Card type:
Visa Mastercard
*Name on Card:
*Account # (No Hyphens):
*CVC:
*Total Amount:
*Exp. Date:
Card holder's Address and Contact Information
*Address:
*City: *State/Prov.: *Zip Code (P.C.):
*Email:
*10 digit Phone:
Comments:

Azzini Communication, LLC • Coaches Call 7235 Algonquin Dr. • Cincinnati, Ohio USA 45243 PH 513-745-8900 FX 513-561-0070