N.B. If you wish only to sign up for ABTAnet Pipex Dial, and pay by credit card, you may complete a standard Pipex Dial form and return it directly to Pipex. YOU MUST QUOTE: "ABTAnet OFFER" AND YOUR ABTA NUMBER AT THE TOP OF THE FORM to benefit from the ABTAnet rate. The amount payable is £202.68 (£169.49 plus £3.00 P&P plus VAT.) Otherwise print out a copy of this form, and send it, completed, with your cheque, made payable to A.B.T.A. to ABTAnet Offer, ABTA. 55-57 Newman Street, London W1P 4AH.
Name :............................................
Company Name:............................................................
Address :............................................................
Postcode :.....................
ABTA Number : ....................................
Telephone No:..........................................
Fax No. :.......................................... Please register my company for the following service (tick one [ ]) and forward me detailed instructions on my chosen publishing option: ABTAnet Pipex Dial Only £202.68 (£169.49 plus £3.00 P&P plus VAT.) [ ] ABTAnet Pipex Dial plus Standard Option Publishing £290.80 (as above plus £75.00 plus VAT) [ ] ABTAnet Pipex Dial plus Advanced Option Publishing £555.18 (as above plus £300.00 plus VAT) [ ] ABTAnet Standard Option Publishing only £88.13 (£75.00 plus VAT) [ ] ABTAnet Advanced Option Publishing only £352.50 (£300.00 plus VAT) [ ] Please register my company for ABTAnet Link Only
URL of Home Page :..................................................
My five keywords are :..................................................
Please contact me concerning the ABTAnet On-Line Marketing Service [ ]
Please send more information [ ]
I enclose a cheque for ....................... made payable to A.B.T.A.
Signature:.........................................
Date :.................................
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