Your name:_________________________________________________________________________

     Company name:______________________________________________________________________

   Street address:________________________________________________________________________

                  ______________________________Postal code:___________________________________

          Country:________________________________________________________________________

            Phone:_____________________________ Fax:______________________________________

   Current Email :_________________________________________________________________________ 


Place your first and second choice of E-Mail address: (also for your web address)
eg :  johnsm@i4l.com  will give you a web address of www.i4l.com/johnsm/
         
        Choice 1 :__________________________@i4l.com

        Choice 2 :__________________________@i4l.com

Please deliver all E-mail to:
(  ) my fax No.   (  ) my current email address  (  )other______________________

Payment details

Credit Card Information

Type of Credit card:   (   ) Visa      (   ) Mastercard

Name as it appears on the card :___________________________________________________________

Credit Card number :______________________________________Expiry :___-___

I have read and understand the terms and conditions and know that in some countries 
I will be billed seperately for the forwarding of e-mail to a fax machine.


Signature :___________________________________         Date :_____________


Please Post or Fax  this application to :
   
The DigitalMail Exchange Ltd. Eastern Court, 182 -190 Newmarket Road,
 Cambridge CB5 8HE

Tel : 01223 353469    Fax : 01223 571678     E-Mail : admin@i4l.com