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Telephone Service (check all services of interest)
Basic Phone	Residence Business
Features	Call Name & Number Delivery Call Waiting Call Forwarding Voicemail Three Way Calling Continuous Redial Last Call Return Priority Call Speed Calling Other, as noted:
Other Options	Inside Wire Maintenance Inside Wiring Needs Other, as noted:

Broadband/Internet Service (check all services of interest)
Type	Dial Up Only Broadband
Features	6.0 megabit download speed 1.5 megabit download speed 512 kilobit download speed Uncertain (provide description of usage for recommended level of speed or desired speed)

Long Distance Service (check all services of interest)
Level of Estimated Usage (estmated number of long distance minutes used per month)	1 to 50 minutes 51 to 100 minutes 101 to 200 minutes 201 to 400 minutes 401 to 600 minutes 601 to 1000 minutes Greater than 1000 minutes (please specify below)

Cellular Service (check all services of interest)
	Single Plan Family Plan Total Number of Family Users Texting Usage Picture Usage

Other Services of Interest or Things to Know


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