Registration Shared Workstation

Name of the Business*
Name and Last name of the Representative*
Contact Address*
Please provide address from your original country or location.

Address 1 Adress 2 City State/Province Zip Code Country
PHONES:*
Please provide business and cell phones that will allow us to reach you if needed.
Email*
Website

Payment Form
I authorize International Trading Center LLC to charge a monthly rental fee of $260 plus tax (or proportional) for the monthly rental of a Shared Workstation, plus any additional services I request, to my credit card as indicated below. The rental fee will be charged within the first five days of the month. The initial charge to my credit card will be for the days of the current month pending plus a one month rental fee deposit (refundable).
Name*
First Last
Type of Credit Card*
Credit Card Number*
Expiration Date*
Security Code (CVV)*
Billing Address*
Credit Card's Billing Address
Credit Card Billing Address
Fill in only if different form your address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Agree*
- I have read and agree to the - Terms of Service
Comments
This field is for validation purposes and should be left unchanged.

Payment Form