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Ichiban TALK Online Registration Form

Ichiban TALK Online Registration Form

Step.1 Enter
Step.2 Confirm
Step.3 Submit

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Title is required.
State is required.
Type of Call Plan is required.
I agree with the clauses as belowed (Please tick if you agree with it ) is required.
Privacy Policy is required.

The form below is limited to individual customers use. Those wish to apply with a company name will need to fill in a separate document, please contact our customer support center or sales representative directly.
Social Security Number and credit card number will be required in registration process, however due to security concern, it is not required to fill in your SSN and credit card number in below form. Our customer service will contact you directly.

Privacy policy

Title：Required
First Name：Required
Last Name：Required
Social Security Number (SSN)：	Not required here. Our customer support will contact you directly.
Daytime Contact Number e.g.: 123-456-7890：Required
FAX e.g.: 123-456-7890：
Email Address：Required
Re-enter Email Address：Required
Street：Required
City：Required
State：Required
Zip：Required
Telephone Number e.g.: 123-456-7890：Required
Type of Call Plan：Required	Standard Plan 60 Minutes Plan 120 Minutes Plan 180 Minutes Plan 240 Minutes Plan 360 Minutes Plan
Credit Card Number：	Not required here. Our customer support will contact you directly.
Current Long Distance Carrier：
Your Local Telephone Company：
How did you hear about this service?：
Campaign Code Number：
I agree with the clauses as belowed (Please tick if you agree with it )：Required	Agree
Privacy Policy：Required	I have read and agree to the privacy policy.

1. KDDI America customer support center will contact you regarding credit card number and Social Security Number (SSN)

2. The Customer/undersigned hereby orders the above noted KDDI Ichiban TALK service and understands that KDDI America shall provide same, subject to the terms and conditions stated and referenced herein, and the Customer shall accept and pay for all KDDI Ichiban TALK services (the "Services"), subscribed to and utilized by the Customer. The Services shall be provided pursuant to the rates, terms, and conditions noted in this KDDI Ichiban TALK Order Form, and any other applicable agreement, including but not limited to KDDI America, Inc.'s Master Agreement Applicable to International Telecommunications Services (available on www.kddia.com), as modified, amended and revised from time to time (the "Master Agreements"). This Agreement incorporates by reference the terms of such applicable Master Agreements. Customer hereby accepts all of the aforementioned terms and conditions, and certifies that all the information provided in this application are correct and true, and applies for the Services noted above by signing below. The Customer's signature below constitutes Customer's written consent of and subscription to KDDI Ichiban TALK services.

Ichiban TALK Online Registration Form

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