Infotel Directory Listing Request Form

Residential Listings:

I,   do hereby request that my
              (Name to appear in Directory)

telephone number as provided by

be added to the Community Infotel Directory.
               (Name of Service Provider)

My address to be shown is as follows, including Postal Code:

Business Listings:

I, owner of    do hereby request that
                             (Name of Business to be listed)

my business telephone number as provided

by   be added to the Community Infotel Directory.
               (Name of Service Provider)

My business address to be shown is as follows, including Postal Code:

I request my Infotel Yellow Section listing for my business be shown under the heading of:

or the closest heading thereto.

I hereby declare that this is not a cell phone number.

Dated:

** It is the sole responsibility of the business / resident to inform Community Info-Tel Directory of any change in the above noted telephone service.