Fifth Avenue Virtual NYC Office Application

I have read and agree to the terms of service
*Agree to the Terms of Service	Yes No
Click here for Terms of Service
*Your Digital Signature		Type your name
Customer E-Mail
Important: Enter a valid e-mail address. Your email address will be your account number.
*E-Mail:
Virtual Office Service
*Virtual Office Service:
*Initial Account Funds
*Your Name
*Company Name
*Years in Business
*Business Description		MUST be specific.
*Website: http://		If none,type none
*Mail Forwarding Frequency	Weekly Monthly
Virtual Office Add-Ons
License Hang
Mail Notification
NYS Records
NYS Records
Mail Forwarding Information
*First Name:
Middle Initial:
*Last Name:
Company Name
*Address Line 1:
Address Line 2:
Address Line 3:
*City
State / Province:
*Country
*Postal Code / Zip Code:
*Actual Contact Phone Number:		Not Voice Mail
*Cell Phone Number
Phone and Fax Service - Your own Manhattan 212 Phone or Fax Number
Manhattan 212 Phone
Add Professional Greeting Recording:
Add Email Forwarding of Voice Messages:
Transcribe voice mail message & send via text:
Manhattan 212 Fax
Add Email Forwarding of Faxes
Promotional Code
Enter your code:
Grand Total
Grand Total:
Billing Information
*First Name:		Same name as on your card
Middle Initial:
*Last Name:
*Address Line 1:		Where your statement is mailed
Address Line 2:
Address Line 3:
*City:
State / Province
*Country:
*Postal Code / Zip Code:
*Billing Phone Number:
Credit/Debit Card Information
*Credit Card Type
*Card Number:		No dashes or spaces please
*Expiration Month:		From your card
*Expiration Year:		From your card
*CVV2:
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