Order The Motorola Q Now!

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Motorola Q Order Form

Use the form below to enter your Motorola Q handheld order.

Every device eAccess ships is fully activated and ready to use right out of the box! All handheld purchases must be accompanied with an airtime contract for wireless data service. This form gives us all the information we need to complete the airtime contract and fax it to you for your signature to complete your order.


	1yr Contract	2yr Contract
Our Price	$349.99	$299.99
Rebate (forms here)	-$0	-$100.00

Your Final Price (Including All Rebates)	$349.99	$199.99
Get an additional $30 off when you trade-in your old handheld!

I'm purchasing this Motorola Q for...

Myself (Consumer Liable Account)
My Company (Business Liable Account)

Contract Term for Service...

Here's how many Motorola Q handhelds I want...

Quantity

Here's the Verizon Motorola Q plan I want to pick...

Click Here For Plan List

Setup my mobile number...

Setup a new phone number

Here's the area code I want my phone number in:
And the city that I want my phone number in:

Transfer an existing phone number

My current wireless provider that I'm changing from is:
My existing mobile number that I'm transferring is:
-
My billing account number on my current wireless service provider is:

Here's my contact information and where I want you to send my monthly statements...

First Name:
Last Name:
Company Name:
Address:
City:
State:
Zip Code:
Country:
Main Phone Number:
Fax Number:	*Your Airtime Contract will be faxed to this number.
E-Mail Address:
Confirm Your E-Mail Address:	*Tracking information will be Emailed to this address!

Here's where I'd like my new Motorola Q shipped...

	I'd like it shipped to the same address as my billing information above...
First Name:
Last Name:
Company Name:
Address:
City:
State:
Zip Code:
Country:

Here's my company's Federal Tax ID so you can establish credit terms for our company...

Federal Tax ID:	(Needed For Credit Approval)
eAccess Solutions uses this information to review your credit history for the purpose of monthly billing. This information will not be used for any other purpose.

Here's my credit card information for device payment...

Credit Card Type:
Credit Card Number:
Credit Card Expiration Date:	/
This will be billed on your credit card as "eAccess Solutions, Inc".

I'd like my Motorola Q to be shipped as follows...

Preferred Shipping Method:

* All orders ship from Chicago, IL FOB Destination
* Devices are provisioned and shipped within 24 hours of receipt of airtime contract

I have additional comments or requirements. They are below...

Have Questions

Call us at
847-991-7190