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Coalfield Application New

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Coalfield Application New

Highland Communications,LLC
PO Box 1278, 119 Hillcrest Street
Wartburg, TN 37887
(423) 346-4050

Application for New Service

Application Information

Applicant Name:  Date of Birth:  

Co-Applicant Name:    Date of Birth:   

What county do you reside in?  

911 Address:  

Is your mailing address the same as your 911 address?  

Mailing Address:  

Contact Information (where you may be reached) 

Home Phone #:  

Cell Phone #:  

Email Address:   

Plans Available:
*Speeds are approximate and not guaranteed.

Prices do not include taxes or surcharges.

 

 

 

 

 

 

 

 

 

 
The applicant will grant Highland a right of easement to conduct, operate, and maintain a fiber line on the property where the Applicant receives service. The Applicant hereby agrees that in the event of default in the payment of any amount due, and if the account is placed in the hands of an agency or attorney for collection of legal action, to pay an additional charge equal to the cost of collection including agency and attorney fees and court costs incurred and permitted by laws governing these transactions.
 
The applicant will be billed for any installation charges on your first billing statement less any pre-paid installation fee. The installation fee may be $50 and will be applied to your first month’s bill.
 
 This institution is an equal opportunity provider and employer.

 

Please Review & Sign This Document

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Coalfield Application New

Customer Service 1-800-790-2257

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