Greencom

Charities - Join Now

Section 1 - Choose your option

Donate the Difference

Share the Difference

Support

Thank you for choosing Share the Difference.

You receive	We receive
Cheaper rates than your current Eircom rates	€53 per annum €4.49 per month

Section 2 - Charity Details

If you would like to sign up to the Greencom service please choose a charity from the list below that you would like to show your support for.

Charity :

Section 3 - Personal Details

Title
Firstname
Surname
Address1
Address 2
Address 3
County / Area Code (inc Dublin area codes)

Section 4 - Line and Account Details

If you don't have your Account Number to hand, don't worry, please complete the phone number detail and the remainder of the this form. Our customer service team can contact you at a suitable time to get the remaining detail.

Account Number
Telephone Number
Second Telephone Number
Third Telephone Number

If you don't have your account number, please fill in the boxes below.

You can contact me any

Between

and

	Area Code	Phone Number
Daytime Number
Evening Number
Mobile Number
Email Address

Section 5 - Authorisation

You must check each of the boxes below to begin service with Greencom.

I authorise Greencom to active the above account numbers on my behalf.
I am over 18
I am authorised to act on behalf of the household in this matter.
I agree to to Greencom's Terms and Conditions of Service (Click here to view the T's & C's)

Section 6 - Notifications

I would like my details passed to my charity
I would like my charity to keep me updated with news and futher information.