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

Application for New Service

Applicant Name:                  Date of Birth:  

Co-Applicant Name:             Date of Birth:  

911 Address:  

Mailing Address:  

Application Information                                                                             Co-Applicant Information

Employer:     Employer:

Employer Phone #: Employer Phone #:  

Contact Information (where you may be reached)

Home Phone #:  Cell Phone #:  

Email Address:  

Plans Available:
*Speeds are approximate and not guaranteed.

Would you like to lease a Wireless router?  

The undersigned (hereafter called “the applicant”) agrees to take service from a corporation organized under the laws of the State of Tennessee, under the name of Highland Communications, LLC. The Applicant will grant to the corporation a right-of-easement to construct, operate, and maintain service on the property where the Applicant receives service. The Applicant assumes no personal responsibility for any debts or liabilities of the corporation and is expressly understood his private property is exempt from the execution for any such debts or liabilities. The Applicant hereby agrees that in the event of default in the payment of any amount due, and if this 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.