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Mobile Device Order Form
Mobile Device Order Form
First Name:
Last Name:
PO Box Address:
Mobile Number:
Contact Number (Optional):
Email Address:
Phone Brand and Series
Select a Brand
iPhone 17 Pro Max
iPhone 17 Pro
iPhone 17 Air
iPhone 17
iPhone 16 e
iPhone 16
iPhone 15
Galaxy S25 Edge
Galaxy S25 Ultra
Galaxy S25 Plus
Galaxy S25
Galaxy S25 FE
Galaxy ZFold 7
Galaxy ZFlip 7
Galaxy A16 5G
Galaxy A35 5G
Pixel 10
Pixel 10 Pro
Pixel 9 Pro XL
Pixel 10 Pro XL
Moto G Play 2024
Moto Razr+
Moto G (2025)
Nubia A76
TCL 502
TCL Flip
XP3plus
XP Pro 5G
Sonim Spot 500
Sonim Spot 500
Raz Mobility Memory Phone
Device Model (Optional)
Storage Size
64GB
128GB
256GB
512GB
Select a Rate Plan
totalSHARE Nationwide 50 GB $90.00
totalSHARE Nationwide 75 GB $95.00
totalSHARE Canada & U.S. 75 GB $100.00
totalSHARE Canada & U.S. 100GB $110.00
totalSHARE Canada, U.S. Mexico $125.00
totalSHARE Data Only 1 Gigabyte $10.00
Basic Nationwide 15GB $80.00
Talk + Text + Data 15 $15.00
Talk + Text + Data 35 $35.00
Talk + Text Plan $40.00
Cellular Safety Plan $229.00 yr
Add-ons (Optional)
Screen Protector
Phone Case
Wireless Device Protection Plan
Apple Care Plus
"ONCE ORDER IS SUBMITTED WE WILL CONTACT YOU TO DISCUSS DETAILS"
THANK YOU !
