Tel: 641-332-2000
Fax: 641-332-2001
Email: gccom@netins.net
Guthrie Center Communications Telephone Application for Service
Date:___________________Date Service Requested___________________Telephone #___________________________
Applicant Information
Last Name: ________________________________ Employer__________________________________
First Name: ________________________________ Employer Address___________________________
Social Security # _______________________________ Employer Telephone #________________________
Co-Applicant Information
Last Name: ________________________________ Employer__________________________________
First Name: ________________________________ Employer Address___________________________
Social Security # _______________________________ Employer Telephone #________________________
Address Information  
Service Address __________________________________State __________ Zip _____________
Mailing Address __________________________________State __________ Zip _____________
Present Telephone No. (______) __________________________ Telephone Co.____________________
Telephone Service Information
Wire Maintenance   Y/N Directory Listing and Adress (how name will look)
Block 900 Numbers   Y/N ________________________________________
Non-Published Number   Y/N ________________________________________
 
Long Distance Carriers:
Interlata(Outside local calling area)___________________ Interlata(Inside local calling area)______________________
Optional Calling Plan______________________________ PIC Freeze Y/N
*You will need to select a long distance carrier. If you wish to change that carrier at any time, you will need to contact Guthrie Center Communications and the carrier of your choice.
 
Automatic Bank Pay:  
Bank Name and Town:_________________________________________________________________________________
 
Account Type: ____Checking ____Savings Account Number:_______________________
 
Signature:____________________________________
Please submit a copy of a voided check
 
Authorization:
I verify that all of the information on this application is correct and that I have read and understand the deposit policy
Signature_________________________________________ Date:_____________________________
   
Guthrie Center Communications Office Use Only GCC#___________________
Deposit Amount $____________ _____ Business _____ Residential Representative _________
 
*Telephone Services: Please select the service(s) below that you would like to order:
 
Residential Rate
Business Rate
__Telephone Service
$ 10.15
$ 18.00
__Call Waiting
$ 1.50
$ 2.25
__Caller ID
$ 6.00
$ 6.00
__Caller ID Blocking
$ 3.25
$ 3.25
__Call Forwarding
$ 1.50
$ 2.25
__Call Forward Busy
$ 1.25
$ 1.25
__Call Forward No Answer
$ 1.25
$ 1.25
__Selective Call Forwarding
$ 3.00
$ 3.50
__Toll Restriction w/Bypass
$ 6.00
$ 6.00
__Automatic Recall
$ 1.50
$ 2.25
__Speed Calling (8 number)
$ 1.50
$ 2.25
__Speed Calling (30 number)
$ 3.00
$ 3.50
__ Automatic Callback
$ 1.50
$ 2.25
__Telemarketing Call Screening
$ 2.95
$ 2.95
 
*Smart Star Packages
__Smart Star Gold
$ 5.50
$ 7.25
(Includes call waiting, call forwarding, three way calling and 8 number speed dialing)
 
__Smart Star Silver
$ 6.50
$ 8.25
(Includes call waiting, call forwarding, three way calling and 30 number speed dialing)
 
__Smart Star Bronze
$ 9.50
$ 10.00
(Includes call waiting, call forwarding, three way calling, 8 number speed dialing and caller ID)
*Installation charges may apply
 
*Voice Mail Packages
__Basic Voice Mail
$ 5.95
$ 5.95
__Enhanced Voice Mail
$ 9.95
$ 9.95
__Enhanced Plus Voice Mail
$ 13.95
$ 13.95
__Greeting Only
$ 5.95
$ 5.95
__Repeat Greeting
$ 6.95
$ 6.95
*one time $15.00 setup fee for voice mail
 
*Toll Free 800 Service
$ 1.00
$ 1.00
(plus 14 cents per minute)
*Long Distance    
__Simply 14 $ 0.14 per minute  
__The 10 Cent Connection $ 2.95 + $0.10 per minute  
__Talk 200 $ 14.95  
__Talk 400 $ 29.95  
__Talk 800 $ 49.95  
__Talk 1500 $ 79.95  
*All fees are monthly charges unless otherwise indicated

CURRENT PICKABLE INTEREXCHANGE CARRIER CUSTOMER SERVICE NUMBERS LIST
CIC IAC IXC NAME Residential Business
9062 PTLD Panora Telecommunications Long Distance 888.755.3700  
0026 ABQ Integrated Communications 310.827.2920  
0071 WSN Broadwing Telecom 800.422.1199  
0063 CIZ Coast International Telecom 800.848.2661  
0081 TTU Covista Inc 800.323.6875 800.805.1000
0123 DVT Americatel (Global Crossing) 800.454.4517  
0211 RTC Frontier Comm Intl Inc RC 800.783.2020  
0222 MCI MCI Worldcom 800.444.2222 800.444.3333
0223 PST Primus Communications 319.341.3835  
0225 INS Iowa Network Services, Inc 800.469.4000  
0244 AUD  Buyers United International 800-363-6177  
0252 LDU Long Distance USA, Inc (Sprint) 800.877.4646  
0284 AVU Amerivision Communications 800.800.7550  
0288 ATT AT &T Communications 800.222.0300 & 800.222.0400  
0333 USS Sprint Communications 800.877.4500 800.877.4020
0354 CDN McLeod*USA 800.500.8000  
0401 NNL Broadwing Telecommunications 800.422.1199  
0432 LTL QWEST 800-860-6440  
0444 ALN Global Crossing (Allnet) 800.466.4600 800.783.2020
0457 TDG Excel Communications 800.875.9235  
0460 IDW Independent Network Services 800.444.2222 800.444.3333
0470 AMJ American Tel Group    
0475 FTL Ionex Telecommunications 800.483.4444  
0500 SCH Global Crossing 800.466.4600  
0555 WTL Worldcom 800.938.6374 800.938.6374
0569 WCU Global Crossing 800.466.4600  
0603 NTZ Incomnet Communication Corporation 800.864.4060  
0621 TZX Winstar Communications 888.946.7827  
0643 CGW Winstar 800.789.7022  
0649 WRK Working Assets 800.789.7022  
0658 ONR Oncor 800.825.5533  
0725 CDN Mcleodusa 800.500.8000  
0732 ATT AT & T Communications 800.222.0300  
0752 EXL Excel Telecommunications 800.875.9535 800.209.8133
0780 MXT Matrix Telecom 800.288.0242 800.822.4326
0795 SGY Caprock Telemanagement    
0810 WHG Winstar Communications 800.555.0011  
0813 AEW American Telecom Enterprises 800.261.5321  
0835 TDD Telecom*USA 800.777.2321  
0888 MCG MCI Worldcom 800.444.2222 800.444.3333
0912 NLG Norlight Telecom 800.876.7842  
0942 QCC QCC Inc 800.444.2222 800.444.3333
0948 SSM Broadwing Communications 800.657.4444 retail 800.994.9638 wholesale
1411 ARE American Express Travel None at this time None at this time
5014 EKG Zone Telecommunications 800.309.0732  
5102 WCA Wiltel Communications 800.348.1834  
5250 CFZ Hickory Tech (Crystal Communications) 319.622.6000  
5253 AEJ Alltel Communications 800.925.5835  
5307 IAM First Fiber Long Distance 712.583.3232  
5314 OTC INS-4A Plan 800.469.4000  
5462 OTC INS-3A Plan 800.469.4000  
5472 IEP Interstate Enterprises Ltd. 641.765.4201  
5513 INQ Fusion Telecomm Intl Inc 800.742.5513  
5672 WIN RSL Communications 800.447.2111  
5820 CXZ Newcell None at this time None at this time
5907 SUJ Spencer Municipal Utilities 712.262.3027  
6225 INS INS Plus 800.469.4000  
6264 POL Onvoy (MEANS Telecom) 800.933.1224  
6286 ADK Advanced Telecom Network Inc 800.444.2222 800.444.3333
6330 LVC Level3 Communications LLC 800.800.7550  
6360 CCQ 360 Degree Long Distance 800.788.2260  
6444 THB Tele-Hub Communications 800.444.2222 800.444.3333
6963 BAX Verizon Enterprise Solutions 800.556.2355 800.636.2355
9999 TR Toll Restrict    
Circle your choice for your long distance carrier  
Telephone Number:___________________ Date:____________ Signature______________________
For Office Use Only: New Install____ PIC Change ____ Completion Date ___________ CSR/Tech_____________
WA___INS___901___902___ PTLD: 14c____-USP341 ($2.95)____Calling Plan: 10c____-USP320 ($14.95) Talk 200____
USP324 ($29.95) Talk 400____-USP328 ($49.95) Talk 800____- USP315 ($79.95) Talk 1500____-USP314($3.95) Talk GC___
Illuminet___ DA___

Request for Preferred Carrier Freeze Billing:

Name:____________________________________________________________

Address:________________________________________________________________

City:______________________________ State:_____________ Zip Code:__________

Please check the service(s) you would like to have frozen with respect to each one of your telephone number(s).  If you have more than one telephone number you need to write down each number and the service you want the freeze on.

Telephone Number: ______________________________________________________

Local Service_________        All Long Distance Service:        Intra____  Inter_____

(If you have more than one telephone number then please mark the additional lines below).

Telephone Number: 2nd line _______________________________________________

Local Service_________          Long Distance Service:                    Intra____    Inter____

 Telephone Number: 3rd line _______________________________________________

Local Service_________        Long Distance Service:          Intra____    Inter____

 Telephone Number: 4th line _______________________________________________

Local Service_________        Long Distance Service:           Intra____   Inter____

Signature:____________________________________

Print:________________________________________

Date:_________________________________________

 

( Please call (641) 332-2000 if you have questions about this form)