Subscription Page

(This page is not functional and is a design draft)

........ Type of the SIP phone: list of phones

........... SIP phone number 1: list of numbers

........... SIP phone number 2: list of numbers

.................... Raison sociale:

................................... Titre:

.................................. Nom:

.............................. Prénom:

............................. Adresse:

.................................. NPA:

................................... Ville:

............................... Tél fixe:

.......................... Tél mobile:

.................................... Fax:

................................. e-mail:

.................... Commentaires:

............................. Contract: signed (fax, post, scan), or

...................................................................................... accepted via e-payment

......................................................................... [Valider]