Unitel - Online Order Step 1 of 2

<BODY vLink=#bb0000 link=#bb0000 bgColor=#ffffff leftMargin=0 background=unitel-order_files/unitel_back.gif topMargin=0 MARGINWIDTH="0" MARGINHEIGHT="0"> <CENTER> <TABLE cellSpacing=0 cellPadding=0 width="100%" border=0> <TBODY> <TR bgColor=#000090> <td width=100%> <center> <P class="top"><font face="Arial" color=FFFFFF> Call an Authorized <b>Unitel Long Distance</b> Agent Today! 1-800-536-0470 Monday-Friday 9am-4pm PST </font> </p> </center></TD> <TR> <TD bgColor=#000090 colSpan=2><IMG height=3 src="unitel-order_files/spacer.gif" width="100%"></TD></TR> <TR> <TD bgColor=#000090 colSpan=2><IMG height=1 src="unitel-order_files/spacer.gif" width="100%"></TD></TR> <TR> <TD bgColor=#000000 colSpan=2><IMG height=3 src="unitel-order_files/spacer.gif" width="100%"></TD></TR></TBODY></TABLE><BR><IMG src="unitel-order_files/unitel1.gif"><BR><FONT face=verdana color=#000080 size=3><B>Unitel Online Service Request Form</B></FONT><BR><BR> <TABLE width=450 align=center border=0> <TBODY> <TR> <TD colSpan=2><FONT size=2>Please fill out the following information to check availability and begin our short two-step order process. </FONT></TD></TR></TBODY></TABLE> <FORM action=https://www.cognigen.net/unitel/order.cgi method=post><INPUT type=hidden value=shopping name=cogid> <TABLE cellSpacing=1 cellPadding=1 width=450 align=center bgColor=#000080 border=0> <TBODY> <TR> <TD> <TABLE cellSpacing=0 cellPadding=1 width=450 align=center bgColor=#ffffec border=0> <TBODY> <TR bgColor=#000080> <TD colSpan=2><IMG height=1 src="unitel-order_files/spacer.gif" width="100%"></TD></TR> <TR bgColor=#000080> <TD align=right><FONT face=verdana color=#ffffff size=1><B>Your Phone Number:</B></FONT><BR><IMG height=1 src="unitel-order_files/spacer.gif" width=150></TD> <TD vAlign=center><INPUT maxLength=15 size=10 name=phone>  <FONT face=verdana color=#ffffff size=1><I>(Including Area Code)</I></FONT></TD></TR> <TR bgColor=#f0f0c0> <TD align=right><FONT face=verdana size=1><B>Your Zip Code:</B></FONT></TD> <TD><INPUT maxLength=5 size=6 name=zip></TD></TR> <TR bgColor=#f0f0c0> <TD align=right><FONT face=verdana size=1><B>Your Email Address:</B></FONT></TD> <TD><INPUT size=30 name=custemail></TD></TR> <TR bgColor=#f0f0c0> <TD align=middle colSpan=2><IMG height=5 src="unitel-order_files/spacer.gif" width="100%"><INPUT type=submit value=" Step 1 of 2 - Check Availability "><IMG height=5 src="unitel-order_files/spacer.gif" width="100%"></TD></TR></TBODY></TABLE> <TABLE cellPadding=3> <TBODY> <TR> <TD><FONT face=arial color=#f0f0c0 size=2><B>IP Address: 66.189.178.151</B> | </FONT><FONT face=arial color=#ffffff size=2>Note that we now accept "free" email addresses, such as hotmail.com and others, because we have gone to a voice verification system. After completing your order, you will receive an automated voice verification to the main billing telephone number you enter above at a time you choose. If you are unable to answer your verification call, please print out our <A href="http://unitelagent.com/loa.cgi?shopping"><B><FONT color=#ffffff>FAXable Application</FONT></B></A> to apply offline. </FONT></TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></A><BR><BR><BR> <HR width=450> <FONT face=verdana size=1> <CENTER>Questions? Please visit our online <A href="http://unitelagent.com/cs.cgi?shopping"><B>Customer Service Center</B></A></FONT><BR><BR> <DIV align=center><FONT size=1>© 2002 Cognigen Networks Inc. <BR> <P><BR> <P></P></FONT></DIV></CENTER></FORM></CENTER> <center> Find Unitel Long Distance at these other websites: </center></body></html> </BODY>