Name:

Home Address:

Phone Number:

Phone Type: Smart Phone - $200 + tax Flip Phone - $75 + tax Basic Phone - $25 + tax

Type of Service:
Full Service - $100 + tax
Limited Service - $50 + tax
Basic Service - $30 + tax

Phone Cover - $15 + tax
Blue Tooth Headset - $50 + tax
Wall Charger - $10 + tax
Car Charger - $20 + tax