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Application for New Service
What County do you reside in?
911 Address
911 Address
City
State/Province
Zip/Postal
Country
Is your mailing address the same as your 911 Address?
Mailing Address
Mailing Address
Apt.
City
State/Province
Zip/Postal
Country
What services are you interested in?
Please check one.
I would like residential bundle services.
Select the services you would like to order.
Select the business services you would like to order.
Residential Plans Available
Business Plans Available
Residential Internet with Phone
Business Internet with Phone

Campbell Internet

Campbell Residential Plans Available
Campbell Business Plans Available

Coalfield Internet

Coalfeld Residential Plans Available
Coalfield Business Plans Available

Phone

Phone Service
Select Your Calling Features
Long Distance
Note: It is the customer's responsibility to contact your selected carrier to establish yourself as their customer and find out what calling plans are available.

This company will make every effort to ensure that your telephone service is connected to the long distance company you choose. In the event your service is inadvertently connected to a
different company, we will assume liability only to the extent of connecting your chosen company at the earliest opportunity after you notify us.

Television

Basic Services
Premium Channels
Additional Services

Bundles

Bundles
KY prices are $1 more for retransmission fee.
Would you like to upgrade your Bundle?
Would you like to lease a Wireless Router - $5.95/month?
Have you had service with us before?
Has present location ever had services with us before?
TN Customers Only: Do you reside in the City Limits?
Please select which type of bill you wish to receive.
KY Customers Only: What fire district do you live in?
Are you interested in automatic payments, if yes, we will contact you to discuss the 2 different options we offer.
A customer service professional will call to collect the $10 for membership and other fees when processing your application. You will be billed for any installation charges on your first billing statement less any pre-paid installation fee.

The undersigned (hereafter called “the Applicant”) hereby applies for membership and agrees to take telephone service from a corporation organized under the laws of the State of Tennessee, under the name of Highland Telephone Cooperative, Inc. The applicant will grant the Cooperative a right of easement to conduct, operate, and maintain a telephone line on the property where the Applicant receives telephone service. The applicant, by becoming a member, assumes no personal responsibility for any debts or liabilities of the Cooperative, 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 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.

This institution is an equal opportunity provider and employer.

Credit: Your credit may be checked with the credit bureau. If credit is unacceptable, you may be required to pay an advanced deposit and
installation fee. You may be notified by letter of this amount. The deposit may vary between $50 to $100 depending on previous bills with us.
The installation fee may be $50 and will be applied to your first month’s bill. The deposit will be held for 12 months and will be refunded on your billing statement.
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.
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