SIGN UP FOR HIGH-SPEED INTERNET

Choctaw Telephone CompanyHigh-Speed Internet Service Agreement

Thank you for choosing Choctaw Telephone Company. All Fields highlighted in (*) are required fields.

“To get our High-Speed Internet you must also sign up for Telephone Service”

(417) 491-4111 Or (877) 850-7360


First Name*

Middle Name

Last Name*

Mailing address*

Phone number*



CHOCTAW Communications High-Speed Internet Access

Residential High-Speed Internet Access
Service Options and Charges - 24 Month Contract

Business High-Speed Internet Access
Service Options and Charges - 24 Month Contract


“That not all speeds are available at all locations”

Note: Actual speeds may vary. See Service Level Agreement on reverse side of this form for actual factors that may cause speeds to vary.


Modem/Router Lease $7.99



Installation Services


Surge Protection



Firewall Protection



Virus Protection



Wireless Security




E-mail Accounts “Optional”

-You may create a CHOCTAW Communications email address if you wish.
-Passwords should be at least 8 characters and contain lower / uppercase letters, number, and at least one special character (&,$,@,%, or !).

E-mail Address

Current Email*

Password


Customer agrees the information they're submitting is accurate.

Initials*

New terms and conditions


Choctaw Telephone Co.

Come By Our Office:
Choctaw Telephone Company
PO Box 428
Louisburg, Ks. 66053

Call Us:
Office: (417) 491-4111 or (877) 850-7360
FAX: (417) 491-4120
Trouble Reporting: (417) 491-4110