Apply For Service

Use this form to provide us with your basic contact information and details about the service you would like. After the form is submitted, a CusterTel team member will be in contact with you soon.

Apply for Service

Applicant

Name
Name
First
Middle
Last
Please re-enter your email to confirm

Spouse

Name
Name
First
Middle
Last

Business Name

Billing Address

Address
Address
City
State/Province
Zip/Postal

Service Address

Address
Address
City
State/Province
Zip/Postal
Do you own or lease/rent this property?

Applicant Credit Report

I GIVE CUSTER TELEPHONE PERMISSION TO RUN MY CREDIT REPORT. I ALSO ACCEPT THAT MY ELECTRONIC SIGNATURE BELOW WILL ACT AS A STANDARD, LEGALLY BINDING SIGNATURE.

Spouse Credit Report

I GIVE CUSTER TELEPHONE PERMISSION TO RUN MY CREDIT REPORT. I ALSO ACCEPT THAT MY ELECTRONIC SIGNATURE BELOW WILL ACT AS A STANDARD, LEGALLY BINDING SIGNATURE.

Service

Which service would you like to apply for?
Which type of internet would you like?
Available service types are dependent on location.
Select a Residential Fiber/Cable Internet Plan
Select a Residential DSL Internet Plan
Select a Residential Fixed Internet Plan

CPNI Information

Select a security question from the lists below. Your answer will be noted on your account to verify your identity before accessing your account if your password is forgotten. Please note these questions will also be used if and when you use Triangle’s electronic billing.

The following individuals have my permission to inquire about or make changes to my account (include first and last name(s).

Person 1:
Person 1:
First
Last
Person 2:
Person 2:
First
Last
Person 3:
Person 3:
First
Last
Person 4:
Person 4:
First
Last