PLEASE PRINT THIS PAGE, COMPLETE, SIGN AND RETURN BY POST (WITH YOUR CHEQUE)
OR BY FAX (IF PAYING BY CREDIT CARD).

To: ADCALL, PO Box 3000, LONDON, N20 9BR, UK         FAX: +44 (0)870 116 3223

From:

title __________ firstname:________________________ surname:________________________________
(If paying by credit card, this must be the same name that appears on your credit card.)

company/trading name:____________________________________________________________________

address:________________________________________________________________________________

________________________________________________________________________________________

email:___________________________________________________________________________________

telephone:_________________________________ fax:___________________________________________

I understand that an adcall0871 number:

• can be connected to my European land-line (cannot be a mobile number).
• can only be called from the UK.
• will cost UK callers 10p per minute at anytime.
• costs me nothing to use apart from the initial cost detailed below of €39 for the first number and (optionally) €30 for a second number (for fax?), including GB VAT at 17.5%.

please tick
	I enclose my payment cheque made payable to Adcall
	Please charge £__________ to my credit card detailed below.

card type: ________________________________________

card number:   ___| ___| ___| ___|     ___| ___| ___| ___|     ___| ___| ___| ___|    ___| ___| ___| ___|

valid from:    ___| ___| ___| ___|  (MM/YY) [may not appear on your card]

expiry date:    ___| ___| ___| ___|  (MM/YY)

*security code:    ___| ___| ___|  (see explanation below) [optional]

issue number:    _____________  [may not appear on your card]

SIGNATURE:___________________________________________ DATE:___________________________

*The card security code is a number printed on the card. The number is not embossed on the card and hence not printed on receipts etc. making it much harder for anyone other than the cardholder to know what the code is. This will help prevent 'cardholder not present' fraud. A security code is now printed on the vast majority of credit/debit cards. The format and position of the security code varies across card schemes. Some cards have a three-digit number printed at the end of the cards' signature strip. Some (AMEX cards for example) have a four digit number on the front of the card. Some card issuers refer to this number as the 'Security Code', others as the 'personal security code' and others as 'Card Verification Value'. In addition, it may also go by the name of 'CVV2' for Visa Cards, 'Card Verification Code' (CVV) for Mastercard/Eurocard and 'Security Code' for AMEX cards.