Interpage Fax by email, Fax to E-Mail, Paging Gateway, Voice Gateway and Ancillary Services Signup Form

Hello, and thank you for applying for service with us!

This form provides information on signing up with Interpage. It may be printed out directly from your web browser, or, alternately, a PDF Signup Form is also available any may be printed out from any PDF viewer (such as Adobe Acrobat) for submission to Interpage.

To activate an Interpage account, please submit a completed form via either fax or postal mail (fax and postal information for this form are provided below). While we will accept a completed application with scans of this form and your credit card as e-mail, we do not advise this as this would subject the scan (image) of your credit card to third parties on the e-mail path between your site and Interpage.

This form is a generic form with can be used to apply for any Interpage service. An OutFax-specific signup form is also available which may be used to apply for a variety of plans. Prospective customers interested in OutFax service trials may utilize the OutFax Trial Form. Most of the non-custom Interpage Services are iterated via the check-boxes on this form.

Please select a service or services which you wish to apply for, and in the space provided indicate the rateplan(s) desired. For example, if you are applying for Paging Gateway service for $10 per month (Paging Gateway Plan 001), you would check the "Paging Gateway" box and then write in "001".

For rapid activation, payment and billing may be arranged by credit card, and is required for Basic and/or Tier I accounts. Credit Card payment generally ensures that we can have most accounts set up within a business day, and often less. We gladly accept the American Express Card, Visa, Mastercard and Discover. A photocopy of both sides of the given credit card is required for activation; WE CAN NOT PROCESS AN APPLICATION WITHOUT A LEGIBLE COPY OF BOTH SIDES OF THE GIVEN CARD.

We also accept check payments from individuals or companies for Tier II or higher accounts (generally $50/month base rate before usage). Sorry, check payment is not available for accounts less than Tier II.

Companies and other applicants for Tier II (or higher) rate plans may apply with a Business Credit Application for postpay in conjunction with this service agreement. A copy of the Business Credit Application may be found on our WWW Form Server; please log in as guest (lower case) and do not use a password.

We accept the following cards:



For immediate sign-up with a credit card, please fill out/edit the form below and fax it back to us at +1 (650) 292-1600. Please fill out all applicable items. If you any questions regarding this form or how to complete it, please give us a call at +1 (650) 331-3900 during Pacific Business hours or send us a message using our Support/Inquiry Submission Page

At the very minimum, we require your name, address, phone number to reach you at, Business Credit Application/BCA (for check payment if not paying any applicable fees in advance), credit card #, expiration date, security code, signature, and photocopy/imprint of the card (credit card), valid student ID (Educational Discount), and all sign-ups require a signature indicating that you agree to abide by our terms of service.

Our Terms of Service may be reviewed on Interpage's Terms of Service and Policies page, or via telnet access by logging in to interpage.net as a guest without using a password.

If you do not have access to a fax, you may mail your application to:

       Interpage NSI
       Mail Stop 2001, Attn: Activations, Building #2
       Box 4022
       Hartford, CT
       06147
       USA

Generally, most account types can be activated in one business day or less. However, in some cases, we may need to configure our system for your paging company, fax provider, Internet Service provider, etc., which may require slightly more time. We will not bill you until your account is properly configured and operational.

If you intend to pay by check (Tier II and higher accounts) and are not applying in conjunction with a Business Credit Application, please contact Interpage at +1 (510) 315-2750 during Pacific Business hours so we can assign a start date for your account and calculate the first month's fees. You may then print out this form (or the PDF), and mail it to us with your payment to be received no later than the assigned start of service date. We will then activate your account a few days after we receive the check and completed form from you.

If you intend to pay by check (Tier II and higher accounts) and will be submitting a Business Credit Application, please print out this form (or the PDF) and fax or mail the completed forms back to Interpage. We will notify you after we have verified credit and have activated your account.

If you have any questions about signing up, or other questions about our service, please use our Support/Inquiry Submission Page, or call +1 (650) 331-3900. Our fax number is +1 (650) 292-1600. (An alternate fax of +1 (617) 850-0420 is also available.)

Thank you for your interest in Interpage!

INTERPAGE GENERIC ACTIVATION FORM

       Address:.................................................................................

       City, State, Zip:.......................................................................

       Day voice phone:.....................................................................

       Evening voice phone:...............................................................

       Pager for us to reach you at:....................................................

       Fax phone:.............................................................................

       Email for us to reach you at:.....................................................

The user ID will be your email address, e.g., myid@interpage.net. (If the ID you select is currently in use on our system, we will try to find something close to it. Feel free to include second and third choices.)

       Preferred user ID:...................................................................

Please select a service(s) and indicate a rateplan from the service list below. If the service you are applying for is not indicated, please check the "Other" box, and write in the service and desired rateplan.

       [] OutFax Plan:______________________________________________

       [] InFax Plan:_______________________________________________

       [] FaxUnlimited Plan:________________________________________

       [] FaxUp Plan:_______________________________________________

       [] Paging Gateway Plan:______________________________________

       [] DirectPage Plan:___________________________________________

       [] WebFaxPro Plan:__________________________________________

       [] WebAlert Plan:____________________________________________

       [] OutVoice Plan:____________________________________________

       [] LobbyByFax Plan:_________________________________________

       [] TAP/IXO Paging Dispatch Gateway Plan:____________________

       [] LinkAlert Plan:___________________________________________

       [] Other Service Type:___________________ Plan #:____________

If this is a new activation and/or change of credit card billing, please read this statement and sign it. (Signature is required for service.)

I am aware of and fully understand all of Interpage's policies concerning my service with Interpage Network Services Inc. (INSI). I agree to abide by these policies, and understand that willful, negligent, or flagrant disregard for the policies set forth in the policy statement, or any other behavior which unreasonably compromises the stability, security, or operability of the Interpage system, will constitute sufficient grounds for immediate suspension and/or termination of service, at the sole discretion of INSI. I hereby waive all claims which I may assert against Interpage for service disruptions, outages, and difficulties, and understand and agree that I will not hold Interpage responsible for any losses, financial or otherwise, which I may experience as a result of a service difficulties.

I agree that if my account includes a contract service period (generally but not limited to a period of time during which I am required to maintain an account with Interpage) that I will make all payments up to and including the final payment of my contract term.

I agree that should I wish to cancel service I shall notifiy Interpage of my desire to do so in writing and that e-mail cancellations or concomitant correspondence will not be accepted. I understand that all cancellations will take place on the last day of a given billing cycle and that Interpage does not offer prorated cancellations.

I further agree that if paying by credit card that I will uphold the terms of my credit card agreement.

Please enclose a legible photocopy or imprint of your credit card.
Thank you! (Required for activation)

      Credit Card Number:.................................................................

      Exp. Date:................... Credit Card Security Code:......................

      Printed Name:..........................................................................

      Date:................. Signature:......................................................

To download this activation form in Adobe Acrobat (PDF) format,
click here.

Mailing Address:

    Interpage Network Services, Inc.
    Mail Stop 2001 Attn: Activations, Building #2
    Box 4022
    Hartford, CT 06147

    Fax Signup: +1 (650) 292-1600, alternate: (617) 850-0420 (please specify "Activations" on your cover sheet to all faxes sent to the 617 fax number).

A copy of the Interpage Policy statement can be found on our Web from server, by telnet with a "guest" login, or a copy may be sent to you via e-mail or regular mail upon request.

For additional information, you may Return to the Interpage Home Page or contact us via email, postal mail, telephone or fax.

Rev 0048/2006, (c)INSI
Last modified 01/09/2007