Readlyn Telephone Order Now Form

Order Now:

Please add the following services to my account. I understand I will receive a confirmation e-mail within 72 hours verifying that these services have been added to my account:

Please change my current services to the services in the package I have marked below:

	Total Connection	$44.95/month
	Super Charged	$59.95/month
	Biz Saver	$59.95/month
	Add a block of 100 long distance minutes to my package	$9.00/month
	Add Cable TV service to my package	$24.95/month

Phone Features

	Call Waiting/Cancel Call Waiting	$.50/month
	Call Forwarding	$.50/month
	Speed Dial (8 or 30 numbers)	$.50/month
	Three-Way Calling	$.50/month
	Inside Wire Maintenance	$.50/month
	Caller ID Name & Number	$1.00/month
	Caller ID Blocking	$1.00/month
	Anonymous Call Rejection	$1.00/month
	Call Forward- Busy	$1.00/month
	Call Forward- No Answer	$1.00/month
	Selective Call Forwarding	$1.00/month
	Automatic Recall (*69)	$1.00/month
	Automatic Callback (*66)	$1.00/month
	Selective Call Rejection	$1.00/month
	Selective Call Acceptance	$1.00/month
	Teen Line (Distinctive Ring)	$1.00/month
	Distinctive Ring Call Waiting	$1.00/month
	Warm Line	$1.00/month
	Call Trace	$1.00/month

*I understand that, if this is my first time adding any calling features, I will be billed a one-time $14.00 charge. If I already have at least one calling feature, I will not be billed this one-time charge.

Long Distance:
	Readlyn *10¢ per minute long distance plan
	Readlyn 14¢ per minute long distance plan

Nationwide Plans:
	100 minutes	$7.00/month
	500 minutes	$35.00/month
	1,000 minutes	$70.00/month
	1,500 minutes	$105.00/month
	2,000 minutes	$140.00/month

	1-800 number
	Calling Card
*I understand that I will be billed a $3.95 monthly fee for the Readlyn 10¢ per minute long distance plan

Cable TV:
	Basic Cable	$24.95/month
	HBO	$10.00/month
	Cinemax	$10.00/month
	STARZ and Encore	$10.00/month

Internet:
	Basic 128K Internet	$20.00/month
	High Speed Internet	$39.95/month
	SecureIT Plus	$5.95/month

Note: For i wireless service and any other services you don’t see here, please call Readlyn Telephone at 279-3375!

I authorize Readlyn Telephone to charge my account for the services marked above.

Full Name Required

Company Name, if applicable (as it appears on your telephone bill):

Current Phone Number(s): Required

Address (to where your telephone bill is sent): Required

E-mail address:

initial: Required

Date: Required

The information you submit will not be distributed to any other parties. We appreciate your business!