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Order Form
Order Form
Lea Burns
2023-03-13T12:08:15-07:00
Highline Services Order Form
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Account Information:
Name
*
First
Last
Email
*
Phone
*
Address
*
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Billing Address (If different than residential)
Address Line 1
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Services:
Telephone Service:
Residential Service* = $19.25/Mo
Business Service* = $29.95/Mo
Non-Listed = $.50/Mo
Non-Published = $1.00/Mo
Telephone Service:
Residential Service* = $19.25/Mo
Business Service* = $29.95/Mo
Other Calling Features Not Listed:
Long Distance:
Yes
No
Inside Wire Maintenance:
Yes = $3.00/Mo
No
High Speed - A La Carte Internet
10Mbps - $59.95/Mo
25Mbps - $89.95/Mo
55Mbps - $109.95/Mo
Residential Bundles (Internet & Phone)
10/1 Mbps = $74.95/Mo
25/3 Mbps = $89.95/Mo
55/10 Mbps = $109.95/Mo
100/25 Mbps = $119.95/Mo
Includes these features: • Residential Phone Service • Caller ID and Call Waiting
Residential Wi-Fi Home Solutions:
Wi-Fi Connect Home Limited: $18.95 - (Includes 1 Router and 1 Mesh Unit)
Wi-Fi Advanced Connected Home: $24.95 - (Includes 1 Router and 2 Mesh Units)
Additional Products & Services:
Connect Protect AntiVirus (Monthly Package) - $2.99/mo. (covers up to 3 devices) $1.25/mo for each additional device
Connect Protect AntiVirus (Yearly Package) - $29.99 for 1-year (covers up to 3 devices) $1.25/mo for each additional device
Promo Code (if applicable):
Phone
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