NAME _______________________________________________________________________________

ADDRESS ____________________________________________________________________________

        ____________________________________________________________________________

MAIN PHONE # _______________________________________________________________________

CONTACT NAME _______________________________________________________________________

TYPE OF SERVICE:      [_]EQUAL ACCESS      [_]INWATS 800      [_]TRAVEL CARD
TYPE OF ACCOUNT:      [_]TELSTAR RESIDENTIAL     [_]TELSTAR COMMERCIAL

I AUTHORIZE TELSTAR COMMUNICATIONS, INC. TO BE MY AGENT OR REPRESENTATIVE
CONCERNING LONG DISTANCE SERVICES AND INTERACTING WITH THE APPROPRIATE LOCAL
EXCHANGE CARRIER, AND I UNDERSTAND THAT VARTEC TELECOM WILL BE THE UNDERLYING
CARRIER TO ACCOMPLISH THIS ACTION.  I AM MAKING THIS MY SELECTION FOR MY PRIMARY
LONG DISTANCE LATA AND INTRA-LATA CARRIER.  I FURTHER UNDERSTAND THAT THIS CHANGE
WILL RESULT IN A NOMINAL ONE TIME CHARGE FROM MY LOCAL EXCHANGE CARRIER.

SIGNATURE ________________________________________________ DATE ____________________

LIST ALL TELEPHONE NUMBERS INDICATING WHICH ARE FAX OR MODEM:

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