VMC-PPS New Member Information Form
  
  
  
       
The asterisks ( * ) below, indicate the minimum
REQUIRED data necessary to become a
Voice Mail Central Personal Privacy Service member.
  Mr./Miss/Mrs./Ms.*:  
  First Name*:  
  Last Name*:  
  Street Address Line 1*:  
  Street Address Line 2:  
  City*:  
  State*:  
  Zip/Postal Code*:  
  Billing Telephone Number*:  
 

Home Phone*     Office Phone*

 
  Hours we can reach you at this number*:  
  Date of Birth (MM-DD-YY)*:  

 

I'm 18 years old or older and
duly authorized by the telephone account
owner to make changes and or incur
charges on this telephone account.
Yes*  No*

 

 

Voice Mail Central is $19.95 per month
with a one-time setup fee of $19.95.
Do you authorize TeleQuery to bill you
for this service?  Yes*  No*

 

  E-mail Address*:  
  Salesperson's E-mail Address:  
 
 
After you click the button above, in about 30 seconds,
you'll see your VMC-PPS account number,
and the number to our Member Service Department.
 
  
 
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