Billing Information:

Your Name: Prefix:
Address:    
Address Continued:    
City:    
State:    
Zip Code:    
County:    
Home Phone Number:    

Physical Location (if different from Billing Location)

Your Name: Prefix:
Address:    
Address Continued:    
City:    
State:    
Zip Code:    
County:    
Home Phone Number:    

Phone Number(s)

Telephone Number 1:
Telephone Number 2:: (If applicable)

Do you need telecommunications for your business? Email us at info@senior-inet.com for a quote

Customer Options:

E-Mail Bill:
E-Mail Address:
Paper Bill ($1.50/mo. extra):
Local Phone Company:

Authorization to change carriers: By clicking on "Sign Me Up", I hereby authorize idea! Communications Group, Inc. and C-COM to be my intraLATA and interLATA long-distance carrier. I designate idea! Communications Group, Inc. and C-COM to act as my agent for the preferred carrier change. This agreement authorizes idea! Communications Group, Inc. and C-COM to obtain a copy of my service and equipment billing records and to notify my local phone company of the change. I understand that this will result in a change of my long distance carrier. I also authorize idea! Communications Group, Inc. and C-COM to have my carrier choice service protection (PlC Freeze) lifted to make this change possible. I also understand that, due to this change, the local telephone company may assess a on-time fee on my telephone bill for each number listed. Customerís use of any common carrier services provided by idea! Communications Group, Inc. and C-COM constitutes acceptance of the terms and conditions of this agreement.