Planet X Forms


ORDER INFORMATION
Associate Id
First Name
Last Name
Email Address

PICK YOUR PHONES
Primary Phone
Brand
Model
Second Phone
Brand
Model
Third Phone
Brand
Model

PICK YOUR PLANS
Primary Phone Number
	Or Check Here for New Number
Phone Plan
Second Phone Number
	Or Check Here for New Number
Phone Plan
Third Phone Number
	Or Check Here for New Number
Phone Plan
	I understand there is a $10.00 port charge per number ported.
	I agree there is one-month set-up fee, $25.00 activation and $25.00 programing fee per phone.

CREDIT CARD INFORMATiON
Name As It Appears On Credit Card
	I agree to TMI Telecom's Terms & Conditions regarding this sale.
Credt Card Number
CVV2
Expiration Date
Billing Address of Credit Card
City
State
	I understand there is a $10 Courtesy Billing Fee per service plan monthly
	I hereby authorize Target Management, Inc. to charge my credit card for this purchase.

Zip

NEXT SUBMIT FORM AND COMPLETE ORDER PROCESS
You Will be directed to the NEXT STEP to process your order information and choose your equipment, service fees, and plans...