Blink Vigilance
Blink Telepresence

BASIC RESIDENTIAL APPLICATION

SELECT YOUR PACKAGE

Standard Residential Line
Smart Choice Gold view
Smart Choice Silver view
Smart Choice Bronze view

PERSONAL DETAILS

Title
First Name
Last Name
Date of Birth
Primary ID Type
Primary ID Number
Secondary ID Type
Secondary ID Number
Email Address
Contact Number (Home)
Contact Number (Office)
Contact Number (Mobile)
Service Address
Billing Address (if different from previous)

EMPLOYMENT DETAILS

Job Title
Employer Name
Employer Address
Employer Contact Number

BASIC LINE DETAILS

Line with Free With White Page Listing ($31.00 and Installation $70.00)

OR Line with No Directory Listing ($31.00 and Installation $70.00)

ADDITIONS

Internal Wiring Required? ($225 Installation)
Yes No
An Extension with a Handset ($70 Installation & $6 Monthly)
Yes No
An Additional Jack - No handset provided ($72.50 Installation)
Yes No

CHOOSE YOUR CALLING FEATURES

FREE FOR ONE MONTH WHEN YOU SIGN UP ONLINE

SMARTCHOICE GOLD LINE DETAILS

SmartChoice Gold with Free White Page Listing ($250.00 Monthly and $150.00 Installation)

OR SmartChoice Gold with No Directory Listing ($250.00 Monthly and $150.00 Installation)

ADDITIONS

Internal Wiring Required? (No cost during Line Installation)
Yes No
An Extension with a Handset ($6 Monthly and $70 Installation)
Yes No
An Additional Jack - No handset provided ($72.50 Installation)
Yes No

FREE CALLING FEATURES WITH SMARTCHOICE GOLD

EVEN MORE VALUE

Medstar Nurse Advice Helpline ($8.65 Monthly and $25.00 Annually Administration fee applies)
Yes No

SMARTCHOICE SILVER LINE DETAILS

SmartChoice Silver with Free White Page Listing ($180.00 Monthly and $150.00 Installation)

OR SmartChoice Silver with No Directory Listing ($180.00 Monthly and $150.00 Installation)

ADDITIONS

Internal Wiring Required? (No cost during Line Installation)
Yes No
An Extension with a Handset ($6 Monthly & $70 Installation)
Yes No
An Additional Jack - No handset provided ($72.50 Installation)
Yes No

FREE CALLING FEATURES WITH SMARTCHOICE SILVER

EVEN MORE VALUE

Medstar Nurse Advice Helpline ($8.65 Monthly and $25.00 Annually Administration fee applies)
Yes No

SMARTCHOICE BRONZE LINE DETAILS

SmartChoice Bronze with Free White Page Listing ($100.00 Monthly and $150.00 Installation)

OR SmartChoice Bronze with No Directory Listing ($100.00 Monthly and $150.00 Installation)

ADDITIONS

Internal Wiring Required? (No cost during Line Installation)
Yes No
An Extension with a Handset ($6 Monthly & $70 Installation)
Yes No
An Additional Jack - No handset provided ($72.50 Installation)
Yes No

FREE CALLING FEATURES WITH SMARTCHOICE BRONZE

EVEN MORE VALUE

Medstar Nurse Advice Helpline ($8.65 Monthly and $25.00 Annually Administration fee applies)
Yes No

LIST YOUR TALK N SAVE NUMBERS

COUNTRY
1.
2.
3.
4.
4.
5.
DESTINATION

Location

http://www.blinkvoice.tt/index.cfm/1,350,979,0,html

Copyright © Blink Broadband 2012