                  RESIDENTIAL SERVICE REQUEST FORM
      
_________________________________________________________________________________________
NAME>                            
_________________________________________________________________________________________
                              (EXACTLY AS IT APPEARS UNDER CURRENT BILLING)

SOC. SEC. #>
ACTUAL STREET ADDRESS [NO P.O. BOX]> 
CITY>                                                                                          STATE>                       ZIP>
COUNTY>
BILLING ADDRESS, IF DIFERENT FROM ABOVE>

___________________________________________________________________________________________
SERVICE INFORMATION:

ENTER EACH TELEPHONE NUMBER INCLUDING AREA CODE. 
TOP NUMBER SHOULD BE YOUR BILLING NUMBER.  
LIST ADDITIONAL NUMBERS ON SEPARATE SHEET IF NECESSARY.

AREA CODE>                                   NUMBER>
AREA CODE>                                   NUMBER>
AREA CODE>                                   NUMBER>
AREA CODE>                                   NUMBER>

                                  [THE FOLLOWING IS NECESSARY TO INSURE YOUR DISCOUNT]

________________________________________________________________________________________
PRESENT LONG DISTANCE CARRIER                     CURRENT DISCOUNT CALLING PLAN

I WOULD LIKE TO ORDER _____  TRAVEL CARDS.
      
SERVICE AUTHORIZATION
__________________________________________________________________________________________

With this signature I authorize Affinity Fund to change my long distance carrier for the telephone number(S) 
indicated.  I authorize Affinity Fund to notify my local telephone company of this choice.  I understand that I 
can have onliy one primary long distance company for a given telephone number and that my local telephone 
company may impose a charge for this and any later change.

________________________________________________________________________
SIGNATURE                                            DATE

____________________________________________________________________
PRINT NAME

SEND COMPLETED REQUEST FORM TO:                          OR FAX TO: (408) 423-0131
LIGHTHOUSE PRODUCTIONS
P.O. BOX 7885
SANTA CRUZ, CA 95060

CONSULTANT ID CODE: 747-0180


Remember, this Long Distance calling Plan is GUARANTEED to save you at least 10% of your monthly Long Distance Bill.  If you can show that AFI did not save you at least 10% of your first month's Long Distance Charges with us, send us the bill and you will be paid your ENTIRE MONTHLY LONG DISTANCE CHARGES.  That's a guarantee that means something.  
