SMART MEMBER SERVICES VOIP 2 FOR 2 FREE TRIAL ORDER FORM

 
* = required field
Personal Information:
  Full Name: *  
  Address: * Address 2:
  City: * State: *
  Zip: * Telephone: *
  Email: *

  Last 4 Digits
of SSN:
         
Banking Information
  PERSONAL BANK ACCOUNT
  Name Of Your Bank: * Account Type: *
  Routing Number: * (help) Account Number: * (help)
  SMSVOIP Member Plan:  
         
      IP Address:
         
         

 

Terms and Conditions (for complete Terms and Conditions see link below):
1. You have 2 days to enjoy the benefits offered by Smart Member Services.
2. You may cancel the 2 days for $2 offer at any time during the 2 day, however no refund will be offered.
3. To cancel your service please contact customer service at 1-877-805-8849 ext. 1 during the 2 day period.


 

 


Select Print on your Browser to print and retain a copy of the authorization.


 

By checking the box to the left, I understand the terms and conditions and the clicking the "authorization" button below, I confirm that I am the owner of the account identified by the numbers entered above and authorize this merchant to convert my account information entered above into an electronic debit to, my account for the amount of this transaction.

 
 

 

       


   
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