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Order form for Cellular Rental
Last Name: ( required )
First Name,( required )
Address ( required ):
City ,State:
Zip Code:
Country: ( required )
Telephone:
Fax:
Number of phones ( required)
E-mail address: ( required )

Credit Card: (required )    
Credit Card Number:
the ATS representative will  contact you
Expiration Date:  (required ) /
Security Number

Date of arrival in Israel:
( required )
Approximate date of return:
Address in Israel to deliver the cellular phone:
Telephone in Israel:
   

Please provide me with the following services:

Cellular phone Samsung 620 or TELIT - including room charger
Insurance ( $ 0.50 /day )
ear plug ( Free )
A $200 authorization will be held on your credit card per phone.  

Comments/Coupon:
How did you hear about us:

For students: Rates for students for a minimum rental period of 3 months.
Please fill up also the following information:Name of the School in Israel: Student ID:By submitting this application form, you agree to ATS Rental Phone's

Terms and Conditions


For any question you can Contact Us
Please verify again your information before submitting your order.


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