World Link Japan Discount Telecom- Saving customers money on international long distance telephone service

Online Customer Information Change Form

Please fill in all the sections of the customer information change form completely with your current information. Please fill in all the sections even if you are not making changes to that particular section. We want to make sure we have all your current information. The required boxes are marked "required". If you have more than one account number you must fill in a separate change form for each account number.

Please check the appropriate boxes where your information has changed:

World Link Account Number:
Credit Card Number
Credit Card Expiration Date
Address
"Calling from Number"

User/Contact Information

Name:

Name of individual user. Example: Robert Jones
If you are a company, name of company and contact name. Example: ABC Marketing, Inc./ John Smith

Address in Japan:
(with postal code)

When your new account is ready, we mail the information and monthly statements to this address.
Example:
Tiger Mansion 502
Naka-cho 2-5-1
Minami-ku
Tokyo 123-0001

Telephone:

A contact number in case we have questions.
Example: 03 1122 3344, 090 9988 7766

Fax Number:

Please provide a fax number if available.

E-Mail Address:

Please check carefully.
Example: username@domain.com

Language:

Calling Information

The telephone numbers that you wish to use World Link from.

Example: 03 1122 3344
Example: 090 9988 7766

10)

Billing Information

Credit Card Type:

Choose the type of credit card you will use to pay for World Link service. Payment is by credit card only.

Credit Card Number:

Example: 1234 5678 0000 1234

Expiration Date:

Example: 05/2006

Cardholder name

Enter the name exactly as shown on card. It's okay to have a cardholder name different from the name above.

CVV2 Code:

CVV2 code means the 3-digit number at the end of your card number on the back of your credit card. Some cards do not have this 3-digit number, and some cards have no numbers at all on the back. Check the box if your card has no 3-digit number. I Have No CVV2 Code
Example: 123 If your card number is (1234 5678 0000 1234) and the back of your card reads (1234 5678 0000 1234-123).

Credit Card
Billing Address:

Fill this in only if different from the address above.

Additional Information

Notes/Comments:

Additional information about your application, comments on this web site, etc.

Referred By:

Referred by a friend/ relative, Internet search, etc.

Authorization: I (We) do hereby authorize World Link to charge the total amount of my World Link bill to my credit card number as listed above and to request a credit allowance for long distance telemanagement services in the amount up to the figure(s) above. I understand that I will only be charged for services after they have been rendered. I understand that I will receive call details approximately every 28 days only if my usage is at least $20 for that four-week period. I understand that I have 30 days from the date of receipt of the call details to dispute any charges and that all disputes must be in writing via mail to World Link Billing Department, 12F Tokyo-Tatemono Building 1-26-20｡｡Shibuya-ku Tokyo Japan 150-0011. I further agree that in the event my credit card becomes invalid, I will provide World Link with a valid credit card upon request and will pay any and all outstanding balances owed to World Link. This authorization is to remain in effect until written notification from the undersigned to cancel this authority is received by mail.

Yes, I want marketing information. We want people to market our service. Check here if you'd like to receive information.

Click the "Submit" button once. In a few moments you will see "Thank you for your customer information change form." This can take as long as 1 minute. If there's no response after 1 minute, please click again.

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