(To be filled out by the Telephone Company)
The above application for membership accepted by resolution this _______ day of ___________, 20_____ Red River Rural Telephone Association By _____________________________________________________
President of Cooperative
Membership, Credit and Service Application
510 Broadway ~ P.O. Box 136
Abercrombie, ND 58001
Call 701-553-8309 or 1-866-553-8309
Fax: 701-553-8396
www.rrt.net
Date ____________________
1. Billing Name and Address (please print)
Name ____________________________________________ Address __________________________________________ City _____________________________________________ State ____________________ Zip Code _______________ Residential Social Security #_______________________ Business Incorporated Fed. ID# ________________ Bus/Res. Not available in all exchanges, must meet specific criteria Date service is to be connected _______________________
2. Past Service Information
Home telephone # _________________________________ Cell Phone # ______________________________________ Previous phone # __________________________________ Have you had service with our company before? __________ If yes, when? ______________________________________
3. Credit Information
Do you rent your home? Yes _______ No _______
If yes, landlord's name ______________________________ Employed by: ___________________________ years _____ Spouse employed by: _____________________ years _____ Work phone: Applicant ______________________________
Spouse ________________________________ Name & phone # of relative not living with you who knows where you can be reached:
_________________________________________________ Relationship:_____________________Phone #______________
4. Service Location Information
Has there ever been telephone service at this location? Yes -- Who lived here last? ________________________ _________________________________________________
No -- Provide township, range & section or directions. _________________________________________________ _________________________________________________
Name of nearest
neighbor__________________________________________ _________________________________________________
THE UNDERSIGNED hereby applies for membership in the Red River Rural Telephone Association, a Minnesota Cooperative (hereinafter called the “Cooperative.”) As a part of this application, the undersigned agrees as follows:
(a) To purchase from the Cooperative telephone service as specified in the Bylaws of the Cooperative, and, after obtaining membership, continuing to receive service: and
(b) To comply with and be bound by the Articles of Incorporation and Bylaws of the Cooperative, and, any rules and regulations adopted by the Board of Directors. (A copy of the Bylaws can be found in our telephone directory.)
(if signing for a business, please include your title)
Membership #
Phone # Assigned
911 address _______________________________________ County ___________________________________________
MEMBER SERVICE AGREEMENT
Applicant's signature_________________________________________________________
✔
The Federal Communications Commission (FCC) has directed all local telephone companies to provide a subscriber’s billing name and address (BNA) data to long distance carriers when (1) the subscriber accepts a third party or (2) the subscriber has placed a call using a long distance carrier other than the company to which the caller is presubscribed. The BNA information will only be provided when necessary for the long distance carrier to issue proper billing. The FCC has directed that your Billing Name and Address data can only be used by the long distance carrier for billing purposes.
Listed Unlisted Non-published ($1/month) ________________________________________________________
Directory Name
________________________________________________________ Directory Address
________________________________________________________ Additional Listing (25¢ per month)
Customer Owned Leased ________________________________________________________ ________________________________________________________
the nearest whole dollar and the additional amount is pooled in a fund to assist local communities and non-profit organizations. Funds collected help improve life within our communities.
New customers are automatically enrolled in the Common Cents program. Participation is optional and you may change your participation at any time.
MARK THE BOX BELOW IF YOU DECIDE NOT TO PARTICIPATE IN THE COMMON CENTS PROGRAM.
Remove my account from the Common Cents program.
Auto Callback $1.50 Auto Recall $1.50 Call Forwarding – Basic $1.00 Call Forwarding - Busy Line $1.50 Call Forwarding - Don’t Answer $1.50 Call Forwarding - Fixed $2.00
Call Waiting $1.00
Call Waiting ID (requires Caller ID) $2.00 Caller ID – Number Only $3.00 Caller ID – Name & Number $4.50 Distinctive Incoming Ring $5.00 Distinctive RNG/CWT $1.50 Inside Wire Maintenance $1.25 Originating Call Management $3.50 Selective Call Acceptance $1.50 Selective Call Forwarding $1.50 Selective Call Rejection $1.50 Speed Dial - 8 numbers $1.00 Speed Dial - 30 numbers $2.00 Telemarketer Call Screening $2.95 3-Way Calling $1.00 Voice Mail – Basic $3.95 Voice Mail – Enhanced $4.95
Allow 3rd party billing Call charges apply Allow collect calls Call charges apply Caller ID line blocking (residential) No charge
International call block No charge 900 numbers block No charge Restrict long distance calls No charge
Type of service: Residential Business Business/residential Automatic payment options: Auto bank pay Credit card E-bill
CPNI form returned Long distance carrier selected Any interest in the following services: Internet SecureIT Cellular
Deposit required? Y / N Amount $___________________ Date paid ________________
COMMENTS/NOTES ________________________________________________________________________________________
____________________________________________________________________________________________________________ ____________________________________________________________________________________________________________ in which customers have their monthly bills rounded up to Red River Communications has a Common Cents program
BILLING NAME AND ADDRESS INFORMATION
CALLING FEATURES & MONTHLY CHARGES
DIRECTORY
EQUIPMENT
COMMOM CENTS PROGRAM
SERVICE RESTRICTIONS
Common information such as mother’s maiden name, birthday, home address or social security number should NOT be used as a password.
The FCC mandates that all telecommunications companies safe guard Customer Proprietary Network Information (CPNI)
data. In general terms, CPNI is personal information stored and collected by Red River Communications for billing and
provisioning service. Examples of protected information include call detail, services and features subscribed to and
carrier selected. Examples of non-protected information, because it is of public record, include name, address and
phone number if published. Red River Communications will do everything possible to protect the privacy of your CPNI
information. Part of the rule changes by the FCC requires Red River Communications to perform a customer
authentication process anytime you call for protected information about your account or if you come into the office.
The following procedures have been put into place by Red River Communications to comply with these requirements.
● If you come to the office for information
, please bring a copy of your complete bill with you. If you do not have
your bill you will need to provide a valid photo ID before we can share information on your account.
● If you are calling the office
, you need to provide your CPNI password to allow us to share information about your
account. Please create a CPNI password that you would like to use.
Security questions may be set up on your account in the event you call our office to inquire about your account and do
not remember your password. Answering these security questions will allow you to access your account. Please fill out
at least one of the security questions and answers below.
Additional Authorized Contacts:
In addition, information will only be given to the name of the person on the account.
If you would like other people (husband, wife, family, etc) to have access and/or make changes, please provide the
names below of those whom you wish to have access to your account. Remember, all contacts will need to know the
password and security questions when they call in to our office.
Thank you for assisting us in protection your information. If you have any questions, please call our business office at
701-553-8309 or 1-866-553-8309.
Account Holder Name:
Typed or Printed Signature
Password: ______________________________ Phone #: ______________________
Please provide a simple question(s) and answer(s) for the times you need to contact Red
River Communications.
Question 1: Pets name(s)? Answer: ____________________________
Question 2: Favorite color? Answer: ____________________________
Question 3: ____________________________________________________ Answer:____________________________
(Create your own question)
Please identify any additional authorized contacts:
Additional Authorized Contact: _________________________________________________
Additional Authorized Contact: _________________________________________________
LONG DISTANCE CARRIER SELECTION & FREEZE FORM
Subscriber's Name
Requested by Phone #
CARRIER SELECTION:
Long distance service is divided into two calling areas called intraLATA and interLATA.
Long distance companies may choose to serve one or both LATAS. This map is also shown in the front section of the telephone directory. See the attached list of available carriers.
The Fargo/Brainerd area in white
is your intraLATA calling area.
Everywhere outside the white area
is your interLATA calling area.
interLATA: change from present carrier _______________________ to new carrier ________________________
(name of carrier) (name of carrier)
Carrier's 4-digit ID code (shown on long distance carrier list): ____________________________
intraLATA: change from present carrier _______________________ to new carrier ________________________
(name of carrier) (name of carrier)
Carrier's 4-digit ID code (shown on long distance carrier list): ____________________________
To ensure proper billing, please contact carriers when selecting or disconnecting their services.
FREEZE REQUEST (optional)
To avoid being "slammed," meaning your long distance carrier(s) is changed without your permission, you can "freeze" your long distance carrier(s). Then NO carrier change can be made UNLESS you contact your local telephone company.
A "FREEZE" IS FREE. Mark below to "freeze" your carrier(s). Also, contact your local telephone company
to remove a freeze.
________ Freeze my carrier(s) for both LATAs. ________ Freeze just my intraLATA carrier. OR
________ Freeze just my interLATA carrier.
Signature Date
Please complete and return this form to Red River Communications.
Automatic volume discounts
apply when RRLD charges are:
* Red River Long Distance savings plan rates apply to all (intraLATA and interLATA) long distance calls.
$0 to $19.99 =
12¢ min.
$20 to $39.99 =
11.65¢ min.
$40 to $79.99 =
11.3¢ min.
$80 to $199.99
=
10.6¢ min.
$200 or more =
9.2¢ min.
For more information call
1-866-553-8309 toll-free or
701-553-8309
If you want to change to Red River Long Distance, please complete this form
LATA Selection -
Long distance service is divided into two calling areas intraLATA,
(calls within a LATA or area) and interLATA (calls between LATAS or area).
Carriers may serve one or both LATAS.
For a map of the LATAS calling area, see page 22 in our telephone directory.
Please change and freeze my InterLata carrier to Red River Long Distance ______
(please check)
Please change and freeze my IntraLata carrier to Red River Long Distance _______
(please check)
To ensure proper billing, please contact carriers when selecting or disconnecting their service.
Name_____________________________________________________________
Signature _______________________________________________________
Phone #___________________________________________________________
Please sign me up for the - (select one)
Call
“60”
Minute Plan
(60 minutes for $5.95/month) __________
Call
“200”
Minute Plan
(
200 minutes for $15.95/month) _________
Call
“350”
Minute Plan
(350 minutes for $24.95/month) __________
Call
“600”
Minute Plan
(600 minutes for $39.95/month) __________
Call
“1000”
Minute Plan
(
1000 minutes for $59.95/month) _________
Direct dial calls within the United States. Each call is rounded up to a full minute.
Name _____________________________________________________
Phone # ___________________________________________________
Signature __________________________________________________
Call 701-553-8309 or 1-866-553-8309 toll-free.
Red River Long Distance Savings Plans
Red River Long Distance Savings Plans
Red River Long Distance Forms
Just 12¢ a minute
Day or Night
Anywhere in the USA.
If you already have Red River
Long Distance service, simply
call our office to select one of
the plans below.
Call
“60”
Minute Plan
(60 minutes for $5.95/month)
Billed in full minutes. Overage is 12¢/min.Call
“200”
Minute Plan
(200 minutes for $15.95/month)
Billed in full minutes. Overage is 10¢/min.Call
“350”
Minute Plan
(350 minutes for $24.95/month)
Billed in full minutes. Overage is 9¢/min.Call
“600”
Minute Plan
(600 minutes for $39.95/month)
Billed in full minutes. Overage is 8.5¢/min.Call
“1000”
Minute Plan
(1000 minutes for $59.95/month)
Billed in full minutes. Overage is 8¢/min.Each call is billed in 6-second increments with a 30-second per-call minimum.
and return it to
Red River Communications - P.O. Box 136 - Abercrombie, ND 58001.
To switch to Red River Long Distance, complete and return this
form to
Red River
Communications
- P.O. Box 136 - Abercrombie, ND 58001.
AUTHORIZATION FORM
FOR AUTOMATIC PAYMENT
I authorize Red River Communications and the financial
institution named below to initiate entries to my checking
account or credit card. This authorization will remain in
effect until I notify the company in writing to cancel it.
Red River Communications will have a reasonable
oppor-tunity to act on it. I can stop payment by notifying my
bank 3 days before my account is charged. I can have the
amount of an erroneous charge immediately credited to
my account up to 15 days following issuance of my bank
statement or 60 days after posting, whichever occurs first.
Auto Bank or Credit Card Pay
Authorization Form
Automatically pay your monthly bill!
Automatically pay your monthly bill!
_________________________________________________ (Financial Institution Name)
_________________________________________________ (Financial Institution Address)
_________________________________________________ (City, State, Zip Code)
__________________________________________________ (Bank Transit Number)
__________________________________________________ (Checking Account Number)
Monthly Credit Card Payment or Auto Bank Pay
(Deduction from credit card or auto bank occurs on 6th to 8th each month)
Billing name as it appears on Credit Card (Please Print) Credit Card Number
Credit Card Number
Credit Card Number
Billing name as it appears on Credit Card (Please Print) Billing name as it appears on Credit Card (Please Print)
Please send a
voided check
___________________________________________________ (Company)
___________________________________________________ (Billing Name - please print) (as it appears on bill)
___________________________________________________ (Telephone Number)
___________________________________________________ (Address)
___________________________________________________ (City, State, Zip Code)
