Order Form for USB Modem Rental

Order Form for USB Modem Rental
*Rental Plans   Each Supplementary 1MB: $2
*Rent Quantity  
Delivery Information
*Delivery Address in China  
*Hotel Checking In Date ( Month/Day/Year )  
*Item to be Returned to Address  
*Date of Picking Up ( Month/Day/Year )  
Customer Information
Mr. Ms. 
*First Name  
*Last Name  
*E-mail Address  
*Business Phone   Area Code Included Please
Your Message  
By submitting this application form, you agree to China Mobile Phones USM Modem Rental
Terms and Conditions.            
I declare that I am the credit card holder and that I am authorized to sign for the full value of this order. I agree to pay for USB rental, data plan, delivery, picking up charges and VAT of 10% incurred by me.
*By entering your initials here, you agree to the terms and conditions set forth above:  

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