Order Form for TeleSecure services
To signup for TeleSecure services please fill out this form thoroughly and press the "Submit Now" button. You can also signup by phone at any time by calling TeleSecure Toll Free at: 800-982-1845 or by calling TeleSecure directly at: 714-680-6600 Your TeleSecure account will be setup and instructions to setup your TeleSecure service will be Emailed to you. Click here for TeleSecure Services and Pricing User Information (Required fields are marked by *): Company: *Name: *Address 1: Address 2: *City: *State: *Zip Code: Country: *Phone: *Email Address: Select a User Name and Password: *Enter a User Name: *Enter a Password: Your User Name and Password are used to retrieve your email and to login to your TeleSecure accounts. Your User Name also forms your email address. You will have three email addresses under telesecure.com, cruznet.com and cruznet.net. For example, if you chose a User Name of 'smith', then your email addresses will be smith@telesecure.com, smith@cruznet.net and smith@cruznet.com. Your User Name must be at most 10 characters and may include Alphabetical letters and digits. Your password must be between 5 and 15 characters and may include lower case letters, digits, underscore, period and dash. Please write down your User Name and Password. Select Account Type: TeleSecure VPN PROXY Service No Setup fee, $10.00/Month, or $100/Year TeleSecure VPN PROXY + Email Service No Setup fee, $15.00/Month, or $150/Year Select Payment Period: Monthly Quarterly Semi-Annualy Annualy (Receive 2 months free) Select Payment Method: *Payment Method : American ExpressVisa Master CardChecking Account *Credit Card No: *Exp Date: *Bank Name (If Paying by Checking Account): *Bank ACCOUNT Number (If Paying by Checking Account): *Bank Routing Number (If Paying by Checking Account): Back to TeleSecure Home Page TeleSecure SignUp Form Toll Free Voice: (800) 982-1845 Voice: (714) 680-6600 Sales Information: sales@telesecure.com Prices are subject to change without notice Copyright © 1994-2009 TeleSecure, A Division of Advanced Scientific Applications, Inc.
Company: *Name: *Address 1: Address 2: *City: *State: *Zip Code: Country: *Phone: *Email Address:
*Enter a User Name: *Enter a Password:
Your User Name and Password are used to retrieve your email and to login to your TeleSecure accounts. Your User Name also forms your email address. You will have three email addresses under telesecure.com, cruznet.com and cruznet.net. For example, if you chose a User Name of 'smith', then your email addresses will be smith@telesecure.com, smith@cruznet.net and smith@cruznet.com. Your User Name must be at most 10 characters and may include Alphabetical letters and digits. Your password must be between 5 and 15 characters and may include lower case letters, digits, underscore, period and dash.
Please write down your User Name and Password. Select Account Type: TeleSecure VPN PROXY Service No Setup fee, $10.00/Month, or $100/Year TeleSecure VPN PROXY + Email Service No Setup fee, $15.00/Month, or $150/Year Select Payment Period: Monthly Quarterly Semi-Annualy Annualy (Receive 2 months free) Select Payment Method: *Payment Method : American ExpressVisa Master CardChecking Account *Credit Card No: *Exp Date: *Bank Name (If Paying by Checking Account): *Bank ACCOUNT Number (If Paying by Checking Account): *Bank Routing Number (If Paying by Checking Account): Back to TeleSecure Home Page TeleSecure SignUp Form Toll Free Voice: (800) 982-1845 Voice: (714) 680-6600 Sales Information: sales@telesecure.com Prices are subject to change without notice Copyright © 1994-2009 TeleSecure, A Division of Advanced Scientific Applications, Inc.
*Payment Method : American ExpressVisa Master CardChecking Account *Credit Card No: *Exp Date: *Bank Name (If Paying by Checking Account): *Bank ACCOUNT Number (If Paying by Checking Account): *Bank Routing Number (If Paying by Checking Account):
Prices are subject to change without notice
Copyright © 1994-2009 TeleSecure, A Division of Advanced Scientific Applications, Inc.
