&lt;!DOCTYPE HTML PUBLIC &quot;-//W3C//DTD HTML 3.2 Final//EN&quot;&gt; &lt;HTML&gt; &lt;HEAD&gt; &lt;TITLE&gt;&lt;/TITLE&gt; &lt;!-- Set Meta Tags --&gt; &lt;meta type=&quot;description&quot; content=&quot;An overview of MCI Long Distance products and services for your business.&quot;&gt; &lt;meta type=&quot;keywords&quot; content=&quot;for your business, small business, medium business, small medium business, business gold, business premier, in state, in-state, state to state, state-to-state, on-net voice services, onnet, on net, international long distance&quot;&gt; &lt;script&gt; function requiredFields( form ){ if( form.Area_Code.value.length &gt; 0 &amp;&amp; form.Prefix.value.length &gt; 0 &amp;&amp; form.Phone_Number.value.length &gt; 0 &amp;&amp; form.First_Name.value.length &gt; 0 &amp;&amp; form.Last_Name.value.length &gt; 0 &amp;&amp; // form.Maiden_Name.value.length &gt; 0 &amp;&amp; form.Email_Address.value.length &gt; 0 &amp;&amp; // form.Fax_Area_Code.value.length &gt; 0 &amp;&amp; // form.Fax_Prefix.value.length &gt; 0 &amp;&amp; // form.Fax_Number.value.length &gt; 0 &amp;&amp; form.Business_Name.value.length &gt; 0 &amp;&amp; form.Street_Address.value.length &gt; 0 &amp;&amp; form.City.value.length &gt; 0 &amp;&amp; form.State.value.length &gt; 0 &amp;&amp; form.Zip_Code.value.length &gt; 0 &amp;&amp; form.Authorization_Name.value.length &gt; 0 ){ if ( form.Subject.checked ) { if (form.Subject2.checked) { alert (&quot;Please select any one of the international calling plans.&quot;); return false; } } if (!form.Authorization_longdistance.checked) { alertMsg(); return false; } if ( form.Local_Toll_Service.checked ) { if (!form.Authorization_local.checked) { alertMsg(); return false; } } return true; } alert( &quot;Please fill out all required fields.\nRequired fields are indicated by an asterisk(*)&quot; ); return false; } function alertMsg() { alert(&quot; IMPORTANT NOTE: If you selected Long Distance&quot; + &quot; and/or Local Toll/Instate service, you must check&quot; + &quot; the appropriate box(es) below authorizing the switch&quot; + &quot; of the service(s) you selected. If the appropriate box&quot; + &quot; is not checked, we will be unable to process your order.&quot;); } function submitForm(){ if( requiredFields( document.mailform )) document.mailform.submit(); } &lt;/script&gt; &lt;!-- &lt;script language=&quot;JavaScript&quot; src=&quot;/scripts/global.js&quot;&gt;&lt;/script&gt; --&gt; &lt;SCRIPT LANGUAGE=&quot;JavaScript&quot; SRC=&quot;/scripts/popup.js&quot; TYPE=&quot;text/javascript&quot;&gt;&lt;/SCRIPT&gt; &lt;!-- &lt;LINK rel=&quot;STYLESHEET&quot; type=&quot;text/css&quot; href=&quot;/scripts/global_sbManual.css&quot;&gt; --&gt; &lt;script language=&quot;JavaScript&quot; src=&quot;/scripts/global.js&quot;&gt;&lt;/script&gt; &lt;LINK rel=&quot;STYLESHEET&quot; type=&quot;text/css&quot; href=&quot;/sblocalsignup/styles/global_sb_local.css&quot;&gt; &lt;!--please don&apos;t enable auto tabbing, if marketing wants it back, just we need to enable this-Jana--&gt; &lt;!--&lt;SCRIPT LANGUAGE=&quot;JavaScript&quot; SRC=&quot;/scripts/autotab.js&quot; TYPE=&quot;text/javascript&quot;&gt;&lt;/SCRIPT&gt;--&gt; &lt;/HEAD&gt; &lt;BODY&gt; &lt;table width=&quot;750&quot; border=&quot;0&quot; cellspacing=&quot;0&quot; cellpadding=&quot;0&quot;&gt; &lt;tr&gt; &lt;td width=&quot;743&quot; align=&quot;left&quot; valign=&quot;top&quot; class=&quot;mainbg&quot;&gt; &lt;table width=&quot;743&quot; border=&quot;0&quot; cellspacing=&quot;0&quot; cellpadding=&quot;0&quot;&gt; &lt;!-- ========== LEFT COLUMN ================ --&gt; &lt;tr&gt; &lt;td width=&quot;157&quot; align=&quot;left&quot; valign=&quot;top&quot; class=&quot;mainbg&quot;&gt; &lt;table cellspacing=&quot;0&quot; cellpadding=&quot;0&quot; width=&quot;157&quot; align=&quot;left&quot; border=&quot;0&quot;&gt; &lt;tr&gt; &lt;td valign=&quot;top&quot; class=&quot;innerbg&quot;&gt;&lt;img src=&quot;/images/sbsalesImage.jpg&quot; height=&quot;103&quot; width=&quot;152&quot; alt=&quot;&quot;&gt;&lt;BR&gt; &lt;/td&gt; &lt;/tr&gt; &lt;/table&gt; &lt;/td&gt; &lt;!-- ========== END LEFT COLUMN ================ --&gt; &lt;td width=&quot;586&quot; valign=&quot;top&quot; class=&quot;mainbg&quot;&gt; &lt;!-- Content table indented --&gt; &lt;table cellpadding=&quot;0&quot; cellspacing=&quot;0&quot; border=&quot;0&quot; width=&quot;586&quot;&gt; &lt;tr&gt; &lt;td valign=top width=&quot;586&quot; bgcolor=&quot;#D9E5F2&quot;&gt;&lt;img src=&quot;/images/olsMastbarNoLogin.gif&quot; width=&quot;592&quot; height=&quot;52&quot; alt=&quot;Online Sales Center&quot; align=&quot;left&quot; border=&quot;0&quot;&gt; &lt;/td&gt; &lt;/tr&gt; &lt;/table&gt; &lt;FORM ACTION=&quot;oms.servlet.FormMailerServlet&quot; METHOD=POST onSubmit=&quot;return requiredFields(this)&quot; name=&quot;mailform&quot;&gt; &lt;input type=&quot;hidden&quot; name=&quot;OWASP_CSRFTOKEN&quot; value=&quot;LDQN-10PW-EW8V-LPTN-HG8K-5CV6-3BWK-JCED&quot;/&gt; &lt;input type=hidden name=&quot;airline&quot; value=&gt; &lt;input type=hidden name=&quot;action&quot; value=&quot;send&quot;&gt; &lt;input type=hidden name=&quot;Configuration_Name&quot; value=&quot;sbcafe&quot;&gt; &lt;input type=hidden name=&quot;PMI&quot; value=&quot;&quot;&gt; &lt;input type=hidden name=&quot;CPI&quot; value=&quot;&quot;&gt; &lt;input type=hidden name=&quot;ZCODE&quot; value=&quot;&quot;&gt; &lt;input type=hidden name=&quot;ACCT_TYPE&quot; value=&quot;&quot;&gt; &lt;input type=hidden name=&quot;DOC_TYPE&quot; value=&quot;SBCOR/SEL&quot;&gt; &lt;input type=hidden name=&quot;FULFILLMENT_SUBJECT&quot; value=&quot;MCI Business Value Select&quot;&gt; &lt;input type=hidden name=&quot;PPG&quot; value=&quot;&quot;&gt; &lt;input type=hidden name=&quot;PLAN_CODE&quot; value=&quot;FIRD&quot;&gt; &lt;input type=hidden name=&quot;NOTE&quot; value=&quot;&quot;&gt; &lt;input type=hidden name=&quot;EMAIL_CAMPAIGN_PONOCODE&quot; value=&quot;&quot;&gt; &lt;input type=hidden name=&quot;Next_Page&quot; value=&quot;&quot;&gt; &lt;input type=hidden name=&quot;ACCESS&quot; value=&quot;&quot;&gt; &lt;input type=hidden name=&quot;ACCESS_CODE&quot; value=&quot;&quot;&gt; &lt;input type=hidden name=&quot;MEMBER_NBR&quot; value=&quot;&quot;&gt; &lt;table cellpadding=&quot;0&quot; cellspacing=&quot;0&quot; border=&quot;0&quot; width=&quot;510&quot;&gt; &lt;tr&gt;&lt;td colspan=2&gt;&amp;nbsp;&lt;/td&gt;&lt;/tr&gt; &lt;!--&lt;tr&gt;&lt;td colspan=&quot;2&quot;&gt; &lt;div style=&quot;padding-left:30px&quot;&gt;&lt;img src=&quot;/images/arrow.gif&quot; width=&quot;12&quot; height=&quot;21&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;span class=&quot;headerTextBlue&quot;&gt;Choose Your Services&lt;/span&gt; &lt;br&gt; &lt;img src=&quot;/images/common/clear.gif&quot; width=&quot;2&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot; class=&quot;Hdotline&quot;&gt;&lt;/td&gt;&lt;/tr&gt;--&gt; &lt;tr&gt; &lt;td colspan=2&gt;&lt;div style=&quot;padding-left:30px&quot;&gt;&lt;img src=&quot;/images/arrow.gif&quot; width=&quot;12&quot; height=&quot;21&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;span class=&quot;headerTextBlue&quot;&gt;Choose Your Services&lt;/span&gt;&lt;br&gt;&lt;img src=&quot;/images/products/dt02_ci_horiz_divider.gif&quot; width=&quot;509&quot; height=&quot;7&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=2&gt;&amp;nbsp;&lt;/td&gt;&lt;/tr&gt; &lt;tr&gt;&lt;td colspan=&quot;2&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt; Please complete the following information to order service with MCI. &lt;/div&gt;&lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=2 &gt;&amp;nbsp;&lt;/td&gt;&lt;/tr&gt; &lt;tr&gt; &lt;td colspan=&quot;2&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;Enter your primary business phone number for which you would like service:&lt;/div&gt;&lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=2 &gt;&amp;nbsp;&lt;/td&gt;&lt;/tr&gt; &lt;tr&gt; &lt;td colspan=&quot;2&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Area_Code&quot; SIZE=3 maxlength=3 value = &quot;&quot;&gt; &amp;nbsp; &lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Prefix&quot; SIZE=3 maxlength=3 value = &quot;&quot;&gt; &amp;nbsp; &lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Phone_Number&quot; SIZE=4 maxlength=4 value = &quot;&quot;&gt;&lt;span class=&quot;highlightRed&quot;&gt;*&lt;/span&gt; &lt;/div&gt;&lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=2 &gt;&amp;nbsp;&lt;/td&gt;&lt;/tr&gt; &lt;td colspan=&quot;2&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;Please select which of the following services you would like to add to your account:&lt;/div&gt;&lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=2 &gt;&amp;nbsp;&lt;/td&gt;&lt;/tr&gt; &lt;/table&gt; &lt;table cellpadding=&quot;0&quot; cellspacing=&quot;0&quot; border=&quot;0&quot; width=&quot;510&quot;&gt; &lt;tr&gt; &lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;INPUT TYPE=&apos;hidden&apos; NAME=&apos;MCI_Long_Dist&apos; value=&apos;Yes&apos;&gt; &lt;td width=&apos;20&apos; valign=&apos;top&apos;&gt;&amp;#160;&lt;/td&gt; &lt;td width=&apos;519&apos;&gt;&lt;b&gt;Long Distance Calling - MCI Business Value Select&lt;/b&gt;&lt;br&gt; A great plan for your business if you make mostly state-to-state long distance calls. &lt;a href=javascript:void(popUp(&apos;/servlet/sbcafe?Page=rates_info.html&amp;PopupLink=rates&amp;linkPlan=LongDistance&apos;))&gt;rates &amp;amp; more info&lt;/a&gt;.&lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=&quot;3&quot; valign=&quot;top&quot;&gt;&amp;nbsp; &lt;/td&gt; &lt;/tr&gt; &lt;/table&gt; &lt;!--&lt;tr&gt;&lt;td colspan=2&gt;&lt;hr&gt;&lt;/td&gt;&lt;/tr&gt; &lt;tr&gt;&lt;td colspan=2&gt; &lt;INPUT TYPE=&quot;checkbox&quot; NAME=&quot;In_State_Savings&quot; value=&quot;Yes&quot;&gt;&amp;nbsp; &lt;FONT SIZE=&quot;2&quot; FACE=&quot;arial, helvetica&quot;&gt;&lt;b&gt;Local Toll and In-state Long Distance Discount Calling Plan &lt;/b&gt; &lt;p&gt; A great plan for your business if you make a lot of in-state and local toll calls. &lt;ul&gt; &lt;li&gt;Competitive low rates on both in-state and local toll calls &lt;li&gt;Additional $3 monthly fee applies &lt;li&gt;You must check this box in order to receive even better rates on both in-state and local toll rates &lt;/ul&gt; &lt;/font&gt; &lt;/td&gt; &lt;/tr&gt; --&gt; &lt;table cellpadding=&quot;0&quot; cellspacing=&quot;0&quot; border=&quot;0&quot; width=&quot;510&quot;&gt; &lt;tr&gt; &lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td width=&apos;20&apos; valign=&apos;top&apos;&gt;&lt;INPUT TYPE=&apos;checkbox&apos; NAME=&apos;Local_Toll_Service&apos; value=&apos;Yes&apos; CHECKED&gt;&lt;/td&gt; &lt;td width=&apos;519&apos;&gt;&lt;b&gt;Local Toll/Regional Toll Service (If available in my area)&lt;/b&gt;&lt;br&gt; A smart choice for your business if you want low rates on your local toll/regional toll calls, with no additional monthly fee. &lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=&quot;3&quot;&gt;&amp;nbsp;&lt;/td&gt;&lt;/tr&gt; &lt;/table&gt; &lt;table cellpadding=&quot;0&quot; cellspacing=&quot;0&quot; border=&quot;0&quot; width=&quot;510&quot;&gt; &lt;tr&gt; &lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td&gt;&lt;b&gt;International Calling Plan&lt;/b&gt;&lt;/td&gt; &lt;/tr&gt; &lt;/table&gt; &lt;table cellpadding=&quot;0&quot; cellspacing=&quot;0&quot; border=&quot;0&quot; width=&quot;510&quot;&gt; &lt;tr&gt; &lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td width=&apos;20&apos; valign=&apos;top&apos;&gt;&lt;INPUT TYPE=&apos;checkbox&apos; NAME=&apos;Subject&apos; value=&apos;**BRE**SB/PARTNER/INTL&apos;&gt;&lt;/td&gt; &lt;td width=&apos;519&apos;&gt;&lt;b&gt;MCI Business Value Select International&lt;/b&gt;&lt;br&gt; Sign up for the International Calling Plan for an additional fee of $5.95 per month, and you&apos;ll receive &lt;b&gt;Three Ways to Save&lt;/b&gt; by getting the same low rate per country. Sign up now and save! &lt;a href=javascript:void(popUp(&apos;/servlet/sbcafe?Page=rates_info.html&amp;PopupLink=rates&amp;linkPlan=International&apos;))&gt;rates &amp;amp; more info&lt;/a&gt;.&lt;/td&gt; &lt;/td&gt; &lt;/tr&gt; &lt;tr&gt; &lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;tr&gt;&lt;td colspan=3&gt;&amp;nbsp;&lt;/td&gt;&lt;/tr&gt;&lt;tr&gt;&lt;td width=&apos;47&apos; valign=&apos;top&apos;&gt;&lt;div style=&apos;padding-left: 47px&apos;&gt;&lt;img src=&apos;/images/spacer.gif&apos; width=&apos;1&apos; height=&apos;1&apos; border=&apos;0&apos;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td width=&apos;20&apos; valign=&apos;top&apos;&gt;&lt;INPUT TYPE=&apos;checkbox&apos; NAME=&apos;Subject2&apos; value=&apos;FIRW&apos;&gt;&lt;/td&gt; &lt;td width=&apos;519&apos;&gt;&lt;b&gt;MCI Business Value Select Worldwide&lt;/b&gt;&lt;br&gt; For an additional $8.95 monthly fee, receive reduced rates to select countries all day, every day. &lt;a href=javascript:void(popUp(&apos;/servlet/sbcafe?Page=rates_info.html&amp;PopupLink=rates&amp;linkPlan=world&apos;))&gt;Learn More&lt;/a&gt;. &lt;/td&gt;&lt;/tr&gt; &lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=3&gt;&amp;nbsp;&lt;/td&gt;&lt;/tr&gt; &lt;/table&gt; &lt;table cellpadding=&quot;0&quot; cellspacing=&quot;0&quot; border=&quot;0&quot; width=&quot;510&quot;&gt; &lt;tr&gt;&lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td width=&apos;20&apos; valign=&apos;top&apos;&gt;&lt;INPUT TYPE=&apos;checkbox&apos; NAME=&apos;Toll_Free_800&apos; value=&apos;Yes&apos;&gt;&lt;/td&gt; &lt;td width=&apos;519&apos;&gt;&lt;b&gt;Toll-Free (800) Service&lt;/b&gt;&lt;br&gt;Enjoy the SAME low rate of 5&amp;cent; a minute that you get with your long distance calling plan for state-to-state calls. A $5 monthly fee per toll-free number applies. &lt;p&gt; Note: If you already have a toll-free number and would like to switch it over to MCI, please call Customer Service at 800-727-5555. &lt;/p&gt; &lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=3&gt;&amp;nbsp;&lt;/td&gt;&lt;/tr&gt; &lt;/table&gt; &lt;table cellpadding=&quot;0&quot; cellspacing=&quot;0&quot; border=&quot;0&quot; width=&quot;510&quot;&gt; &lt;tr&gt;&lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;tr&gt; &lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td width=&apos;20&apos; valign=&apos;top&apos;&gt;&lt;INPUT TYPE=&apos;checkbox&apos; NAME=&apos;Calling_Card_Service&apos; value=&apos;Yes&apos; CHECKED&gt;&lt;/td&gt; &lt;td width=&apos;519&apos;&gt;&lt;b&gt;MCI Business Calling Card&lt;/b&gt;&lt;br&gt;Your calling card number will be your 10-digit business phone number plus a 4-digit PIN that you select. &lt;b&gt;Sign up now and get your state-to-state calling card calls to the office for 5&amp;cent; a minute (additional pay phone surcharge applies).&lt;/b&gt; &lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=&quot;3&quot;&gt;&amp;nbsp;&lt;/td&gt;&lt;/tr&gt; &lt;/table&gt; &lt;table cellpadding=&quot;0&quot; cellspacing=&quot;0&quot; border=&quot;0&quot; width=&quot;510&quot;&gt; &lt;tr&gt;&lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td width=&quot;20&quot; valign=&quot;top&quot;&gt;&amp;nbsp;&lt;/td&gt; &lt;td width=&quot;443&quot;&gt;&lt;b&gt;Additional Phone Numbers&lt;/b&gt;&lt;br&gt; Enter up to ten additional phone numbers that you would like added to your MCI account (e.g., fax, modem, internet): &lt;p&gt;Area Code and Phone Number:&lt;/p&gt; &lt;/td&gt;&lt;/tr&gt; &lt;tr&gt;&lt;td colspan=3&gt;&amp;nbsp;&lt;/td&gt;&lt;/tr&gt; &lt;/table&gt; &lt;table cellpadding=&quot;0&quot; cellspacing=&quot;0&quot; border=&quot;0&quot; width=&quot;535&quot;&gt; &lt;tr&gt;&lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td width=&quot;20&quot; valign=&quot;top&quot;&gt;&amp;nbsp;&lt;/td&gt; &lt;td width=&quot;20&quot; valign=&quot;top&quot;&gt;2&lt;/td&gt; &lt;td width=&quot;216&quot;&gt;&lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Area_Code1&quot; SIZE=3 maxlength=&quot;3&quot;&gt;&amp;nbsp; &lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Prefix1&quot; SIZE=3 maxlength=&quot;3&quot;&gt;&amp;nbsp; &lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Phone_Number1&quot; SIZE=4 maxlength=&quot;4&quot;&gt; &lt;/td&gt; &lt;td width=&quot;20&quot; valign=&quot;top&quot;&gt;3&lt;/td&gt; &lt;td width=&quot;212&quot;&gt;&lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Area_Code2&quot; SIZE=3 maxlength=&quot;3&quot;&gt;&amp;nbsp; &lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Prefix2&quot; SIZE=3 maxlength=&quot;3&quot;&gt;&amp;nbsp; &lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Phone_Number2&quot; SIZE=4 maxlength=&quot;4&quot;&gt; &lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=&quot;6&quot;&gt;&amp;nbsp;&lt;/td&gt;&lt;/tr&gt; &lt;tr&gt;&lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td width=&quot;20&quot; valign=&quot;top&quot;&gt;&amp;nbsp;&lt;/td&gt; &lt;td width=&quot;20&quot; valign=&quot;top&quot;&gt;4&lt;/td&gt; &lt;td width=&quot;216&quot;&gt;&lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Area_Code3&quot; SIZE=3 maxlength=&quot;3&quot;&gt;&amp;nbsp; &lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Prefix3&quot; SIZE=3 maxlength=&quot;3&quot;&gt;&amp;nbsp; &lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Phone_Number3&quot; SIZE=4 maxlength=&quot;4&quot;&gt; &lt;/td&gt; &lt;td width=&quot;20&quot; valign=&quot;top&quot;&gt;5&lt;/td&gt; &lt;td width=&quot;212&quot;&gt;&lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Area_Code4&quot; SIZE=3 maxlength=&quot;3&quot;&gt;&amp;nbsp; &lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Prefix4&quot; SIZE=3 maxlength=&quot;3&quot;&gt;&amp;nbsp; &lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Phone_Number4&quot; SIZE=4 maxlength=&quot;4&quot;&gt; &lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=&quot;6&quot;&gt;&amp;nbsp;&lt;/td&gt;&lt;/tr&gt; &lt;tr&gt;&lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td width=&quot;20&quot; valign=&quot;top&quot;&gt;&amp;nbsp;&lt;/td&gt; &lt;td width=&quot;20&quot; valign=&quot;top&quot;&gt;6&lt;/td&gt; &lt;td width=&quot;216&quot;&gt;&lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Area_Code5&quot; SIZE=3 maxlength=&quot;3&quot;&gt;&amp;nbsp; &lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Prefix5&quot; SIZE=3 maxlength=&quot;3&quot;&gt;&amp;nbsp; &lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Phone_Number5&quot; SIZE=4 maxlength=&quot;4&quot;&gt; &lt;/td&gt; &lt;td width=&quot;20&quot; valign=&quot;top&quot;&gt;7&lt;/td&gt; &lt;td width=&quot;212&quot;&gt;&lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Area_Code6&quot; SIZE=3 maxlength=&quot;3&quot;&gt;&amp;nbsp; &lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Prefix6&quot; SIZE=3 maxlength=&quot;3&quot;&gt;&amp;nbsp; &lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Phone_Number6&quot; SIZE=4 maxlength=&quot;4&quot;&gt; &lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=&quot;6&quot;&gt;&amp;nbsp;&lt;/td&gt;&lt;/tr&gt; &lt;tr&gt;&lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td width=&quot;20&quot; valign=&quot;top&quot;&gt;&amp;nbsp;&lt;/td&gt; &lt;td width=&quot;20&quot; valign=&quot;top&quot;&gt;8&lt;/td&gt; &lt;td width=&quot;216&quot;&gt;&lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Area_Code7&quot; SIZE=3 maxlength=&quot;3&quot;&gt;&amp;nbsp; &lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Prefix7&quot; SIZE=3 maxlength=&quot;3&quot;&gt;&amp;nbsp; &lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Phone_Number7&quot; SIZE=4 maxlength=&quot;4&quot;&gt; &lt;/td&gt; &lt;td width=&quot;20&quot; valign=&quot;top&quot;&gt;9&lt;/td&gt; &lt;td width=&quot;212&quot;&gt;&lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Area_Code8&quot; SIZE=3 maxlength=&quot;3&quot;&gt;&amp;nbsp; &lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Prefix8&quot; SIZE=3 maxlength=&quot;3&quot;&gt;&amp;nbsp; &lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Phone_Number8&quot; SIZE=4 maxlength=&quot;4&quot;&gt; &lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=&quot;6&quot;&gt;&amp;nbsp;&lt;/td&gt;&lt;/tr&gt; &lt;tr&gt;&lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td width=&quot;20&quot; valign=&quot;top&quot;&gt;&amp;nbsp;&lt;/td&gt; &lt;td width=&quot;20&quot; valign=&quot;top&quot;&gt;10&lt;/td&gt; &lt;td width=&quot;216&quot;&gt;&lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Area_Code9&quot; SIZE=3 maxlength=&quot;3&quot;&gt;&amp;nbsp; &lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Prefix9&quot; SIZE=3 maxlength=&quot;3&quot;&gt;&amp;nbsp; &lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Phone_Number9&quot; SIZE=4 maxlength=&quot;4&quot;&gt; &lt;/td&gt; &lt;td width=&quot;20&quot; valign=&quot;top&quot;&gt;11&lt;/td&gt; &lt;td width=&quot;212&quot;&gt;&lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Area_Code10&quot; SIZE=3 maxlength=&quot;3&quot;&gt;&amp;nbsp; &lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Prefix10&quot; SIZE=3 maxlength=&quot;3&quot;&gt;&amp;nbsp; &lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Additional_Phone_Number10&quot; SIZE=4 maxlength=&quot;4&quot;&gt; &lt;/td&gt; &lt;/tr&gt; &lt;!--14 lines tag--&gt; &lt;/table&gt; &lt;table cellpadding=&quot;0&quot; cellspacing=&quot;0&quot; border=&quot;0&quot; width=&quot;510&quot;&gt; &lt;tr&gt;&lt;td&gt;&amp;nbsp;&lt;/td&gt;&lt;/tr&gt; &lt;td&gt;&lt;div style=&quot;padding-left:30px&quot;&gt;&lt;img src=&quot;/images/arrow.gif&quot; width=&quot;12&quot; height=&quot;21&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;span class=&quot;headerTextBlue&quot;&gt;Account Information&lt;/span&gt;&lt;br&gt;&lt;img src=&quot;/images/products/dt02_ci_horiz_divider.gif&quot; width=&quot;509&quot; height=&quot;7&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;tr&gt;&lt;td&gt;&amp;nbsp;&lt;/td&gt;&lt;/tr&gt; &lt;tr&gt;&lt;td&gt;&lt;div style=&quot;padding-left:47px&quot;&gt;Please complete the following information to begin enjoying the benefits of MCI!&lt;/div&gt;&lt;/td&gt;&lt;/tr&gt; &lt;tr&gt;&lt;td&gt;&amp;nbsp;&lt;/td&gt;&lt;/tr&gt; &lt;/table&gt; &lt;table cellpadding=&quot;0&quot; cellspacing=&quot;0&quot; border=&quot;0&quot; width=&quot;510&quot;&gt; &lt;tr&gt; &lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td width=&quot;231&quot; valign=&quot;top&quot;&gt;First Name:&lt;/td&gt; &lt;td width=&quot;232&quot; valign=&quot;top&quot;&gt;Last Name:&lt;/td&gt; &lt;/tr&gt; &lt;tr&gt; &lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td width=&quot;231&quot; valign=&quot;top&quot;&gt;&lt;INPUT TYPE=&quot;text&quot; NAME=&quot;First_Name&quot; size=&quot;17&quot;&gt;&lt;span class=&quot;highlightRed&quot;&gt;*&lt;/span&gt;&lt;/td&gt; &lt;td width=&quot;232&quot; valign=&quot;top&quot;&gt;&lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Last_Name&quot; size=&quot;17&quot;&gt;&lt;span class=&quot;highlightRed&quot;&gt;*&lt;/span&gt;&lt;/td&gt; &lt;/tr&gt; &lt;!-- &lt;tr&gt; &lt;td&gt;&lt;FONT SIZE=&quot;2&quot; FACE=&quot;arial, helvetica&quot;&gt;Mother&apos;s Maiden Name:&lt;/FONT&gt; &lt;/td&gt; &lt;td&gt;&lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Maiden_Name&quot;&gt; &lt;FONT FACE=&quot;Helvetica,Arial&quot; COLOR=red size=+2&gt;*&lt;/font&gt;&lt;/td&gt; &lt;/tr&gt; &lt;tr&gt; &lt;td colspan=2&gt;&lt;FONT SIZE=&quot;1&quot; FACE=&quot;arial, helvetica&quot;&gt;Note: This is the security validation code that you will need if you contact Customer Service regarding your MCI Internet account.&lt;/FONT&gt; &lt;/td&gt; &lt;/tr&gt; --&gt; &lt;tr&gt;&lt;td colspan=&quot;3&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;10&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/td&gt;&lt;/tr&gt; &lt;tr&gt; &lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td colspan=&quot;2&quot;&gt;E-mail Address:&lt;/td&gt; &lt;/tr&gt; &lt;tr&gt; &lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td colspan=&quot;2&quot;&gt;&lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Email_Address&quot; size=&quot;30&quot;&gt;&lt;span class=&quot;highlightRed&quot;&gt;*&lt;/span&gt;&lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=&quot;3&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;10&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/td&gt;&lt;/tr&gt; &lt;tr&gt; &lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td colspan=&quot;2&quot;&gt;&lt;INPUT TYPE=&quot;checkbox&quot; NAME=&quot;Special_Offers&quot;&gt;&amp;nbsp;&amp;nbsp; I would like to be contacted about special offers and services from MCI.&lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=&quot;3&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;10&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/td&gt;&lt;/tr&gt; &lt;tr&gt; &lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td colspan=&quot;2&quot;&gt;Fax Number:&lt;/td&gt; &lt;/tr&gt; &lt;tr&gt; &lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td colspan=&quot;2&quot;&gt;&lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Fax_Area_Code&quot; SIZE=3 maxlength=3&gt; &lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Fax_Prefix&quot; SIZE=3 maxlength=3&gt; &lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Fax_Number&quot; SIZE=4 maxlength=4&gt;&lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=&quot;3&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;10&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/td&gt;&lt;/tr&gt; &lt;tr&gt; &lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td colspan=&quot;2&quot;&gt;Name of Business:&lt;/td&gt; &lt;/tr&gt; &lt;tr&gt; &lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td colspan=&quot;2&quot;&gt;&lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Business_Name&quot; size=&quot;17&quot;&gt;&lt;span class=&quot;highlightRed&quot;&gt;*&lt;/span&gt;&lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=&quot;3&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;10&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/td&gt;&lt;/tr&gt; &lt;tr&gt; &lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td colspan=&quot;2&quot;&gt;Street Address:&lt;/td&gt; &lt;/tr&gt; &lt;tr&gt; &lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td colspan=&quot;2&quot;&gt;&lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Street_Address&quot; size=&quot;17&quot;&gt;&lt;span class=&quot;highlightRed&quot;&gt;*&lt;/span&gt;&lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=&quot;3&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;10&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/td&gt;&lt;/tr&gt; &lt;tr&gt; &lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td width=&quot;231&quot; valign=&quot;top&quot;&gt;City:&lt;/td&gt; &lt;td width=&quot;232&quot; valign=&quot;top&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;10&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;State:&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;15&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;Zip:&lt;/td&gt; &lt;/tr&gt; &lt;tr&gt; &lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td width=&quot;231&quot; valign=&quot;top&quot;&gt;&lt;INPUT TYPE=&quot;text&quot; NAME=&quot;City&quot; size=&quot;17&quot;&gt;&lt;span class=&quot;highlightRed&quot;&gt;*&lt;/span&gt;&lt;/td&gt; &lt;td width=&quot;232&quot; valign=&quot;top&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;10&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;INPUT TYPE=&quot;text&quot; NAME=&quot;State&quot; size=2 maxlength=2&gt;&lt;span class=&quot;highlightRed&quot;&gt;*&lt;/span&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;10&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Zip_Code&quot; size=5 maxlength=5&gt;&lt;span class=&quot;highlightRed&quot;&gt;*&lt;/span&gt;&lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=&quot;3&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;10&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/td&gt;&lt;/tr&gt; &lt;tr&gt;&lt;td colspan=&quot;3&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;10&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/td&gt;&lt;/tr&gt; &lt;tr&gt; &lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td colspan=&quot;2&quot;&gt;&lt;span class=&quot;highlightRed&quot;&gt;*&lt;/span&gt; Indicates a required field&lt;/td&gt; &lt;/tr&gt; &lt;/table&gt; &lt;table cellpadding=&quot;0&quot; cellspacing=&quot;0&quot; border=&quot;0&quot; width=&quot;510&quot;&gt; &lt;tr&gt;&lt;td colspan=&quot;3&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;10&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/td&gt;&lt;/tr&gt; &lt;tr&gt; &lt;td colspan=&quot;3&quot;&gt;&lt;div style=&quot;padding-left:30px&quot;&gt;&lt;img src=&quot;/images/arrow.gif&quot; width=&quot;12&quot; height=&quot;21&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;span class=&quot;headerTextBlue&quot;&gt;Authorization&lt;/span&gt;&lt;br&gt;&lt;img src=&quot;/images/products/dt02_ci_horiz_divider.gif&quot; width=&quot;509&quot; height=&quot;7&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=&quot;3&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;10&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/td&gt;&lt;/tr&gt; &lt;tr&gt;&lt;td width=&apos;47&apos; valign=&apos;top&apos;&gt;&lt;div style=&apos;padding-left: 47px&apos;&gt;&lt;img src=&apos;/images/spacer.gif&apos; width=&apos;1&apos; height=&apos;1&apos; alt=&apos;&apos; border=&apos;0&apos;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td width=&apos;20&apos; valign=&apos;top&apos;&gt;&lt;INPUT TYPE=&apos;checkbox&apos; NAME=&apos;Authorization_longdistance&apos; value=&apos;Yes&apos;&gt;&lt;/td&gt; &lt;td width=&apos;489&apos;&gt;I choose MCI to provide long distance telephone service (if selected) for each of the telephone numbers stated above. If MCI is not the current long distance company for the business, I authorize MCI to serve as the authorized agent to effectuate the change of the long distance &lt;nobr&gt;service(s)&lt;/nobr&gt;.&lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=&apos;3&apos;&gt;&lt;img src=&apos;/images/spacer.gif&apos; width=&apos;1&apos; height=&apos;10&apos; alt=&apos;&apos; border=&apos;0&apos;&gt;&lt;/td&gt;&lt;/tr&gt; &lt;tr&gt; &lt;td width=&apos;47&apos; valign=&apos;top&apos;&gt;&lt;div style=&apos;padding-left: 47px&apos;&gt;&lt;img src=&apos;/images/spacer.gif&apos; width=&apos;1&apos; height=&apos;1&apos; alt=&apos;&apos; border=&apos;0&apos;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td width=&apos;20&apos; valign=&apos;top&apos;&gt;&lt;INPUT TYPE=&apos;checkbox&apos; NAME=&apos;Authorization_local&apos; value=&apos;Yes&apos;&gt;&lt;/td&gt; &lt;td width=&apos;489&apos;&gt;I choose MCI to carry local toll calls (if selected) for each of the telephone numbers stated above (if available in my area). If MCI is not the company currently providing local toll service for the business, I authorize MCI to serve as the authorized agent to effectuate the change of the telephone service.&lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=&apos;3&apos;&gt;&lt;img src=&apos;/images/spacer.gif&apos; width=&apos;1&apos; height=&apos;10&apos; alt=&apos;&apos; border=&apos;0&apos;&gt;&lt;/td&gt;&lt;/tr&gt; &lt;tr&gt; &lt;td width=&apos;47&apos; valign=&apos;top&apos;&gt;&lt;div style=&apos;padding-left: 47px&apos;&gt;&lt;img src=&apos;/images/spacer.gif&apos; width=&apos;1&apos; height=&apos;1&apos; alt=&apos;&apos; border=&apos;0&apos;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td width=&apos;20&apos; valign=&apos;top&apos;&gt;&lt;img src=&apos;/images/spacer.gif&apos; width=&apos;1&apos; height=&apos;1&apos; alt=&apos;&apos; border=&apos;0&apos;&gt;&lt;/td&gt; &lt;td width=&apos;489&apos;&gt;You must read the &lt;a href=javascript:popUp(&apos;/servlet/sbcafe?Page=terms_cond.html&amp;PopupLink=terms_cond&apos;) onMouseOver=&apos;window.status=&apos;terms &amp;amp; conditions&apos;;return true&apos; onMouseOut=&apos;window.status=&apos; &apos;;return true&apos;&gt;terms of authorization&lt;/a&gt; before continuing. Together with this page, that document will authorize MCI to become the preferred telecommunications provider for the telephone numbers stated above, for the services selected.&lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=&apos;3&apos;&gt;&lt;img src=&apos;/images/spacer.gif&apos; width=&apos;1&apos; height=&apos;10&apos; alt=&apos;&apos; border=&apos;0&apos;&gt;&lt;/td&gt;&lt;/tr&gt; &lt;tr&gt; &lt;td width=&apos;47&apos; valign=&apos;top&apos;&gt;&lt;div style=&apos;padding-left: 47px&apos;&gt;&lt;img src=&apos;/images/spacer.gif&apos; width=&apos;1&apos; height=&apos;1&apos; alt=&apos;&apos; border=&apos;0&apos;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td width=&apos;20&apos; valign=&apos;top&apos;&gt;&lt;img src=&apos;/images/spacer.gif&apos; width=&apos;1&apos; height=&apos;1&apos; alt=&apos;&apos; border=&apos;0&apos;&gt;&lt;/td&gt; &lt;td width=&apos;489&apos;&gt;Yes! As the person authorized to select telephone service providers for the indicated business, I understand that by entering my name in the box below, I acknowledge that I have read and understood the terms of authorization and authorize MCI to become the business&apos; new preferred telecommunications provider for the services selected. I am at least 18 years of age and legally authorized to change telephone companies for services to the telephone number(s) listed above. I understand that the local telephone company may assess a nominal, per-line service fee to switch the primary carrier for each of the services selected. MCI will issue a credit for each line selected (up to $10 per line for up to 50 lines) to help offset the cost of the charge for switching long distance and/or local toll service (as selected above). By submitting this form I am automatically affixing today&apos;s date to this order. &lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=&quot;3&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;10&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/td&gt;&lt;/tr&gt; &lt;tr&gt; &lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td colspan=&quot;2&quot;&gt;Please type your full name: &amp;nbsp; &lt;INPUT TYPE=&quot;text&quot; NAME=&quot;Authorization_Name&quot; size=&quot;17&quot;&gt;&lt;span class=&quot;highlightRed&quot;&gt;*&lt;/span&gt;&lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=&quot;3&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;10&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/td&gt;&lt;/tr&gt; &lt;tr&gt; &lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td colspan=&quot;2&quot;&gt;Entering my name above will result in a change of the preferred telecommunications provider for the services I have selected for the telephone lines indicated above.&lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=&quot;3&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;10&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/td&gt;&lt;/tr&gt; &lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td colspan=&quot;2&quot;&gt;&amp;nbsp; &lt;/td&gt; &lt;/tr&gt; &lt;tr&gt;&lt;td colspan=&quot;3&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;10&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/td&gt;&lt;/tr&gt; &lt;!--addbuttontag--&gt; &lt;!-- ********************************* SUBMIT ************************************************ --&gt; &lt;tr&gt; &lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td colspan=&quot;2&quot;&gt;&lt;div style=&quot;padding-left: 200px&quot;&gt; &lt;!--&lt;a href=&quot;javascript:submitForm()&quot; onmouseover=&quot;rollButtons(this, img_submit_over);&quot; onmouseout=&quot;rollButtons(this, img_submit_off);&quot;&gt;&lt;IMG SRC=&quot;/images/submit_up.gif&quot; ALT=&quot;Submit&quot; WIDTH=&quot;80&quot; HEIGHT=&quot;17&quot; border=&quot;0&quot;&gt;&lt;/a&gt;--&gt; &lt;!--&lt;input type=&quot;image&quot; src=&quot;/images/bttn_find_plan_off.gif&quot; width=&quot;134&quot; height=&quot;17&quot; border=&quot;0&quot; alt=&quot;Find Your Plan&quot; onmouseover=&quot;this.src=&apos;/images/bttn_find_plan_roll.gif&apos;&quot; onmouseout=&quot;this.src=&apos;/images/bttn_find_plan_off.gif&apos;&quot;&gt;--&gt; &lt;!--&lt;input type=&quot;image&quot; src=&quot;/images/submit_up.gif&quot; ALT=&quot;Submit&quot; WIDTH=&quot;82&quot; HEIGHT=&quot;17&quot; border=&quot;0&quot; onmouseover=&quot;rollButtons(this, img_submit_over);&quot; onmouseout=&quot;rollButtons(this, img_submit_off);&quot;/&gt;--&gt; &lt;input type=&quot;image&quot; src=&quot;/images/submit_up.gif&quot; width=&quot;77&quot; height=&quot;17&quot; border=&quot;0&quot; alt=&quot;Submit&quot; onmouseover=&quot;this.src=&apos;/images/submit_over.gif&apos;&quot; onmouseout=&quot;this.src=&apos;/images/submit_up.gif&apos;&quot;&gt; &lt;/div&gt; &lt;/td&gt; &lt;/tr&gt; &lt;!-- ********************************* SUBMIT ************************************************ --&gt; &lt;tr&gt;&lt;td colspan=&quot;3&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;10&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/td&gt;&lt;/tr&gt; &lt;tr&gt; &lt;td width=&quot;47&quot; valign=&quot;top&quot;&gt;&lt;div style=&quot;padding-left: 47px&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;1&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/div&gt;&lt;/td&gt; &lt;td colspan=&quot;2&quot;&gt;&lt;b&gt;Attention:&lt;/b&gt;&lt;br&gt; An independent verification company will attempt to reach you in the next few days to confirm your MCI long distance choice. For your protection, the independent verification company may ask you a series of questions in order to ensure that you have authorized MCI to switch your long distance. If your confirmation is not verified during this time, we will be unable to activate your MCI long distance account. &lt;/td&gt;&lt;/tr&gt; &lt;tr&gt;&lt;td colspan=&quot;3&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; width=&quot;1&quot; height=&quot;10&quot; alt=&quot;&quot; border=&quot;0&quot;&gt;&lt;/td&gt;&lt;/tr&gt; &lt;/table&gt; &lt;!-- end content --&gt; &lt;/td&gt; &lt;/tr&gt; &lt;/table&gt; &lt;/td&gt;&lt;/tr&gt; &lt;!-- ============ FOOTER =========== --&gt; &lt;tr&gt; &lt;td vAlign=center align=middle width=770 class=&quot;innerbg&quot;&gt;&lt;img src=&quot;/images/spacer.gif&quot; height=1 alt=&quot;&quot; width=1 border=&quot;0&quot;&gt;&lt;br&gt; &lt;!-- &lt;div style=&quot;padding-right: 5px&quot;&gt; --&gt; &lt;script language=javascript type=text/javascript &gt; var sPath = &apos;/images/common/GlobalNavImages/&apos;; &lt;/script&gt; &lt;style type=&quot;text/css&quot;&gt; .footerHR { border-top: #666666 1px solid; z-index: 1; width: 750px; height: 1px; } .footerBody { background: #dbdfc8; } IMG.footerBody { border-bottom-style: none; } .footerBottom { color: #c1c5af; background-color: #666666; height:24px; } .footerlink {font-size: 10px;font-family: Arial; color: #d2d3cc;} A.footerLink:link, A.footerLink:visited { text-decoration: none; color: #d2d3cc; } A.footerLink:hover {font-size: 10px;font-family: Arial; text-decoration: underline; color: #d2d3cc;} select.searchDropDown { font-size: 11px; color: #666666; SCROLLBAR-ARROW-COLOR: #ffffff; font-family: Arial; background-color: #f9faf1; } .searchText { font-size: 11px; color: #666666; font-family: arial; background-color: #f9faf1; } .searchImg { border:0; } &lt;/style&gt; &lt;!-- begin SSL area --&gt; &lt;div style=&quot;padding-left:10px&quot;&gt; &lt;TABLE cellSpacing=0 cellPadding=0 width=750 border=0&gt; &lt;TR&gt; &lt;TD bgcolor=&quot;#D9E5F2&quot; class=footerText vAlign=center align=middle width=743 class=&quot;innerbg&quot;&gt; &lt;IMG height=10 alt=&quot;&quot; src=&quot;/images/spacer.gif&quot; width=1 border=0&gt;&lt;BR&gt; &lt;TABLE cellSpacing=0 cellPadding=0 width=643 border=0&gt; &lt;TR vAlign=top&gt; &lt;TD width=16 bgcolor=&quot;#D9E5F2&quot;&gt;&lt;IMG src=&quot;/images/lock.gif&quot; border=0&gt;&lt;/TD&gt; &lt;TD width=5 bgcolor=&quot;#D9E5F2&quot;&gt;&lt;IMG height=1 src=&quot;/images/spacer.gif&quot; width=5 border=0&gt;&lt;/TD&gt; &lt;TD vAlign=top bgcolor=&quot;#D9E5F2&quot;&gt;&amp;nbsp;We use Secure Sockets Layer (SSL) encryption technology to ensure your personal information is secure and protected.&lt;/TD&gt; &lt;/TR&gt; &lt;/TABLE&gt; &lt;/TD&gt; &lt;/TR&gt; &lt;/table&gt; &lt;/div&gt; &lt;!-- end SSL area --&gt; &lt;!-- Begin footer --&gt; &lt;div style=&quot;padding-left:10px&quot;&gt; &lt;table width=&quot;750&quot; align=&quot;left&quot; cellpadding=&quot;0&quot; cellspacing=&quot;0&quot; border=0 ID=&quot;Table1&quot;&gt; &lt;tr class=&quot;footerBottom&quot; valign=middle &gt; &lt;td valign=middle&gt; &amp;nbsp;&lt;a class=&quot;footerLink&quot; href=&quot;http://global.mci.com/legal/privacy/&quot;&gt; Privacy Policy&lt;/a&gt;&lt;font color=#F1FAF1&gt; | &lt;/font&gt;&lt;a class=&quot;footerLink&quot; href=&quot;http://global.mci.com/legal/&quot;&gt; Legal Notices&lt;/a&gt;&lt;font color=#F1FAF1&gt; | &lt;/font&gt;&lt;a class=&quot;footerLink&quot; href=&quot;http://global.mci.com/publications/&quot;&gt; Service Terms &amp;amp; Rates&lt;/a&gt;&lt;font color=#F1FAF1&gt; | &lt;/font&gt;&lt;a class=&quot;footerLink&quot; href=&quot;http://www.mci.com/sitemap/&quot;&gt; Site Map&lt;/a&gt; &lt;/td&gt; &lt;td align=right style=&quot;FONT-SIZE: 10px; COLOR: #c1c5af; FONT-FAMILY: arial&quot; valign=middle&gt; &amp;#0169; 2005 MCI, Inc. All Rights Reserved&amp;nbsp; &lt;/td&gt; &lt;/tr&gt; &lt;/table&gt; &lt;/div&gt; &lt;!-- end footer --&gt; &lt;script language=javascript type=text/javascript &gt; function selectCountry() { // grab index number of the selected option selInd = document.formSelectCountry.loc.selectedIndex; // get value of the selected option goURL =document.formSelectCountry.loc[selInd].value; //UAT fix #119 if (goURL != &apos;null&apos;) { // redirect browser URL window.location = goURL; } } function SubmitSearch() { //alert (searchforit.col.selectedIndex); document.searchforit.submit(); } function SetImagePath() { imgSearch = new Image(); imgSearch.src = sPath + &apos;MCI_gl_ft_ti_search.gif&apos;; document[&quot;SearchImage&quot;].src=imgSearch.src; imgGo = new Image(); imgSearch.src = sPath + &apos;MCI_gl_ft_btn_go.gif&apos;; document[&quot;GoImage&quot;].src=imgSearch.src; document[&quot;GoCountryImage&quot;].src=imgSearch.src; imgCountry = new Image(); imgCountry.src = sPath + &apos;MCI_gl_ft_ti_mci.gif&apos;; document[&quot;CountryImage&quot;].src=imgCountry.src; } SetImagePath(); &lt;/script&gt; &lt;!-- &lt;/div&gt; --&gt; &lt;!-- top level table --&gt; &lt;/td&gt; &lt;/tr&gt; &lt;/table&gt; &lt;!-- 250 lines --&gt; &lt;!--250AdditionalLinesCustomTag--&gt; &lt;/FORM&gt; &lt;/BODY&gt; &lt;/HTML&gt;