Global Phoneworks 
Global Phoneworks Order Form and Rental Agreement
Please complete the form below. Click the 'Order Now' button to send your order instantly to GPW via secure network connection using Go Daddy SSL. To fax or mail your order Click Here  for a printable PDF Version of this form. For customer service call (800) 556-0530.
*Indicates required fields
  1. Traveler Information
Name: * Phone: *
Fax: Billing Reference:
Email: *
  2. Shipping Information (No Delivery to a P.O. Box)
Attention: * Company:
Address 1: * Address 2:
City: * State: *
Postal Code: * Phone: *
  3. Rental Information
Date you would like to receive the phone: * Date of Departure from the U.S.: *
Date of return to the U.S.: * Rental plan: *
Countries to be visited: * Additional comments:
Referred by: Promotional Code:
  4. Phone Features
Select a 4 digit pin number: *
For your protection, a PIN code is required to turn the phone on. Please select your personal PIN code. GPW will remind you of your PIN when the phone is delivered to you.
Speed Dials:
Global Phoneworks can program up to 5 phone numbers into the phone, including international dialing codes. Please list the numbers and descriptions you would like us to program into the phone.
Phone Number 1: Description:
Phone Number 2: Description:
Phone Number 3: Description:
Phone Number 4: Description:
Phone Number 5: Description:
Equipment Insurance:
Global Phoneworks will insure your rental equipment against loss, theft or damage. Insurance is $25 per rental for a GSM phone with a $150 deductible. For a satellite phone the insurance is $100 per rental with an $800 deductible.
  5. Payment Information
Credit Card Billing Information:
Name as printed on card: * Address 1: *
Address 2: City: *
State: * Postal code: *
Type of card (no debit cards): * Card #: *

Please enter digits only
Expiration date: * CVV (3 or 4 digit code): *
Phones rent for $25 per week with a roundtrip shipping fee of $35 per rental. Please refer to the GPW Airtime Rate Guide for current airtime rates. From time to time, special discounts may apply and will be applied at the time of invoicing. Contact Global Phoneworks for more information regarding savings for groups of two or more persons traveling together.
Terms and Conditions:
By clicking the "Order Now" button below, I acknowledge that I have read the Rental Terms and Conditions and I authorize Global Phoneworks, LLC to charge the above credit card for all applicable rental fees, deposits, usage charges and any other fees as specified in the attached Global Phoneworks Rental Terms and Conditions. I understand that all usage charges may not be billed until up to 120 days after I return the phone.
Global Phoneworks reserves the right to process interim billing if charges exceed $500.00 for any rental period. We also reserve the right to suspend service at any time during the rental period if we are unable to collect funds from form of payment provided.

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