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GCNet
P.O. Box 990
McHenry, MD 21541

E-mail  billing@gcnetmail.net

Phone: (301) 387-3048

Fax: (301) 387-3222
To Print this form: 
Use your Right-mouse button and click anywhere on the form. 
From the Pop-up Menu, Select Print.  After printing the sign-up form, fill in the information and be sure to sign it.  Then snail mail the form to GCNet or drop it by the GCNet office.
Your Name:

 

 Your Social Security No:
Street:  City:  State:   
Zip:
Phone #:   Organization Name:  
Services Desired:
  Outbound Long Distance
  800 # (No additional charge).

Travel Cards:
 # of cards requested________ (No additional charge).

When someone calls your 800#, what is the # of the phone you want to ring.
____________
I hereby authorize PowerNet Global Communications, or its designator, to transfer my long distance service.  I agree to financial responsibility for all charges arising from all long distance services provided.  The service requested will be provisioned only on the approval of credit for the application.  A service charge may be assessed by the local telephone company when they make the carrier change.

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                    Signature                                                      Date