LifeLine Long Distance FREE! Online Application!!:

*required

* First Name:

* Last Name: t

^*E-mail address:

^*First phone line:

Second phone line:

Local carrier: Bell Atlantic Other

Current Long Distance carrier:

Notes:

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Yes, I give LifeLine full permission to switch my Long distance carrier for free and send 10% of my phone bill to Family Heritage Matters (NPO # 51117).