TO: Vighnesh Global Telecommunications
PHONE: 831-464-1212
FAX: 831-464-1333
ADDRESS P.O. BOX 2337
SANTA CRUZ, CA 95063-2337
EMAIL: mail@vighnesh.com
WEBSITE: http://www.vighnesh.com

New customers should fill out this form, print it, attatch their check, and fax it to 831-464-1333. Then, to establish your account with us, mail the form and check to us. You only need to mail the check one time -- after we receive it you can simply fax your checks.

FIRST NAME: LAST NAME:

HOME PHONE : WORK PHONE :

FAX NUMBER: EMAIL ADDR

STREET:

CITY: STATE: ZIP:

New Customer

SERVICE REQUESTED:

(TAPE YOUR CHECK HERE)