Boyce Telecom Inc. LONG DISTANCE SERVICES application FORM

Name

Company Name

Address

City

Province Postal Code

Email Address

Please register these phone numbers (NPA) XXX – XXXX

Please send me a Calling Card

Please call me to establish a toll free number

Visa Master Card

Other

Card Number

Expiry Date

I am authorized to register the telephone numbers in this application and agree to join the Ensync Telecom Program provided by Boyce Telecom Inc. I agree that Ensync Telecom may charge me a 1.5% monthly late payment for all calls, including taxes that are unpaid after sixty (60) days.

All local service and long distance charges are on one monthly invoice.

Signature_________________________ Date_________________

Print this application form,. Sign and date the application form and fax it to

767-3946 (Thunder Bay) or (866) 729-9844 (outside of Thunder Bay).

Boyce Telecom Inc.

5092 Dog Lake Road

Thunder Bay, ON P7B 5E5

1 (866) 273-2345

Tel: (807) 767-6646

Local Fax: (807) 767-3946

Long Distance Fax (866) 729-9844

http://www.boycetelecom.com/

longdistance@boycetelecom.com