Order Primus On Demand
Thank you for you interest in Primus Conferencing. To sign-up for our On Demand conferencing service, please complete the form below. * Are required fields.
Please click here if you need to use the service within 24 hours
COMPANY INFORMATION
Company Name*:
Accounts Payable Contact:
Billing Address (line 1)*:
Billing Address (line 2):
City*:
State*:
Zip Code*:
Country:
USA/Canada
SCHEDULER 1 INFORMATION
Scheduler/User Name*:
Last Name*:
Job Title*:
Telephone*:
Fax:
Email Address*:
Complete only if different than the billing address:
Mailing Address (line 1):
Mailing Address (line 2):
City:
State:
Zip Code:
Country:
USA/Canada
Comments/Specific Instructions:
Account Billing code Activation
Yes
No
ACCOUNT INFORMATION
Are you an existing Primus customer?
Yes, I have a Primus account.
No, I am a new customer.
If you are an existing Primus customer, please enter your account number:
How did you hear about Primus?
Agent Name:
Agent Rep Number:
ADDITIONAL SCHEDULER INFORMATION
Please specify up to four additional schedulers for this account.
SCHEDULER 2 INFORMATION
Scheduler/User Name*:
Last Name*:
Job Title*:
Telephone*:
Fax:
Email Address*:
Complete only if different than the billing address:
Mailing Address (line 1):
Mailing Address (line 2):
City:
State:
Zip Code:
Country:
USA/Canada
Comments/Specific Instructions:
Account Billing code Activation
Yes
No
SCHEDULER 3 INFORMATION
Scheduler/User Name*:
Last Name*:
Job Title*:
Telephone*:
Fax:
Email Address*:
Complete only if different than the billing address:
Mailing Address (line 1):
Mailing Address (line 2):
City:
State:
Zip Code:
Country:
USA/Canada
Comments/Specific Instructions:
Account Billing code Activation
Yes
No
SCHEDULER 4 INFORMATION
Scheduler/User Name*:
Last Name*:
Job Title*:
Telephone*:
Fax:
Email Address*:
Complete only if different than the billing address:
Mailing Address (line 1):
Mailing Address (line 2):
City:
State:
Zip Code:
Country:
USA/Canada
Comments/Specific Instructions:
Account Billing code Activation
Yes
No
SCHEDULER 5 INFORMATION
Scheduler/User Name*:
Last Name*:
Job Title*:
Telephone*:
Fax:
Email Address*:
Complete only if different than the billing address:
Mailing Address (line 1):
Mailing Address (line 2):
City:
State:
Zip Code:
Country:
USA/Canada
Comments/Specific Instructions:
Account Billing code Activation
Yes
No