ICM/AT&T ASSOCIATION LOYALTY PROGRAM

Authorization of Change -- Benefiting Organization: International House, Code: 10284
Billing phone # (______)____________________________________________
Additional phone/residential fax # (______)_____________________
Current long distance carrier: " AT&T ", " MCI ", " SPRINT ", " OTHER "
Average monthly long distance:
" $0-$25 " , " $25-$50 ", " $50-$100 ", " $100-$200 ", " $200+ "

Name as it appears on phone bill:

First Name: _______________________________________________
Last Name: ________________________________________________
Address: __________________________________________________________
Apt#: _______ City ______________________________
State ___________________ Zip: __________________
Country most called:__________________
Native Language___________________________

Do you own a business " yes " " no "
" Yes" , I am an AT&T customer and I want to participate in this ICM program.

" I authorize AT&T to notify my local telephone company of my choice to switch to AT&T for all telephone numbers listed on this form. I understand that I may choose one long distance company for each telephone number and that the local telephone company may charge a small fee for this and any later change. However, I will receive a $25 AT&T certificate to help cover this fee."

Your Signature____________________________________________Date:__________

ICM/AT&T SPECIAL SAVINGS PLANS

Please choose the plan(s) that best suit your needs. Promotions subject to change, call ICM for details at 1-800-426-0015.

" Grand Savings - One rate Offer"
Call any country 24 hours a day, 7 days a week at a flat rate for 6 months (direct dialed calls only).

" AT&T One Rate Domestic Plan"
Call anywhere in the U.S. for $.15/min., anytime, any day, (direct dialed calls only).

MANY THANKS!

PLEASE RETURN TO:
I-HOUSE DEVELOPMENT OFFICE
2299 PIEDMONT AVE.
BERKELEY, CA 94720-2320