Customer Information
Customer Name (Exact Legal Name)
Location Type
Residential
Business
Tax Exempt
We will need a copy of the Exemption Certificate.
Billing Address
Physical Address (if different)
Zip Code
Address
Address
City
City
State
State
Zip
Contact Name
Daytime Telephone No.
Email Address
Fax No.
Federal ID
State Id No.
Social Security No.
Phone Line Information
Phone Number
Service
Service Type
Main Telephone Number
Both
Local
Long Distance
Both
Out Of State Only
In State Only
Additional Telephone Number
Both
Local
Long Distance
Both
Out Of State Only
In State Only
Additional Telephone Number
Both
Local
Long Distance
Both
Out Of State Only
In State Only
Additional Telephone Number
Both
Local
Long Distance
Both
Out Of State Only
In State Only
Additional Telephone Number
Both
Local
Long Distance
Both
Out Of State Only
In State Only
Calling Card
Name On Card
PIN
Quantity
Toll Free
Toll Free Number
Ring To Number
Currently Have
Currently Have
Currently Have
Currently Have
If you would like to add a Toll Free Number to your order, enter a number from the above phone section into the following box that you would like the new Toll Free Number to ring to
.
Terms
Select One
Month To Month
1 Year
2 Year
3 Year
Rates
InterState
IntraState
Calling Card
Toll Free
Cable
Currently Cable is only available in the Deep Creek Lake, Maryland Area.
None
Lifeline Basic Cable TV - ($ 29.99)
Premier Digital Cable TV - ($ 62.50)
Super Saver Cable TV - ($ 75.00)
Gold Cable - ($ 97.50)
Internet
Internet options listed below available in the Deep Creek Lake, Maryland Area only. If you live outside the Deep Creek Lake area please call us for availability of alternate internet options in your area.
None
Economy - ($ 20.99)
Standard - ($ 39.99)
Express - ($ 55.99)
Advanced - ($ 79.99)
Comments
Comments
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