Fill in this form if you wish to receive the cell phone in your hotel when you arrive. Please add 3 hours in your arrival time. Example: If you are at the airport at 11am, put your arrival time as 2pm.
Name:
Address:
City:	Country:
Zip Code:	E-mail:
Home phone:
(Country Code / City Code / Phone Number)
Office number:
(Country Code / City Code / Phone Number)
Fax number:
(Country Code / City Code / Phone Number)
Choose the best package for you:
International - Make / receive national and international calls. R$ 3,70 per minute made / received.
National - Make national calls. Receive national and international calls. R$ 1,90 per minute made/received.
Delivery date:	Delivery time:
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Janeiro Fevereiro Marco Abril Maio Junho Julho Agosto Setembro Outubro Novembro Dezembro 2007	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 0 H   00 05 10 15 20 25 30 35 40 45 50 55 M
Hotel Name (In Rio de Janeiro):
Hotel Phone Number:	Number of Phones you will need: