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	Origination/Termination

Thank you for your interest in origination and termination opportunities with Net2Phone.
Please provide the following information so that we can better serve you.

Required fields are marked with an asterisk (*)
First Name:	*
Last Name:	*
Job Title:
Company Name:	*
Address:
City:
State/Region:
Country:	*
Postal Code:
Phone:	*
Fax:
E-mail:	*
Company Web site:
Please list the top locations you would like to buy from Net2Phone:
Location #1:
Location #2:
Location #3:
For these locations, please estimate the amount of minutes per month you would send to Net2Phone:
Location #1:
Location #2:
Location #3:
Please list the top locations you would like to sell to Net2Phone:
Location #1:
Location #2:
Location #3:
For these locations, please estimate the amount of minutes per month you would have to receive from Net2Phone:
Location #1:
Location #2:
Location #3:
Interconnect Type:

Please briefly describe your company and any other opportunities in which you may be interested:

	*