Please complete and submit the form below to order service. A credit check is required, and a security deposit may be necessary. Upon receipt of your order, a customer service representative will contact you, usually within one business day, to confirm your order and schedule an installation. For service and pricing information, click here for residential or click here for business. Thank you for choosing Globe!

Name:
Address:
City / State / Zip Code:
Work phone:	ext.
Home phone:
Mobile phone:
Fax:
Email address:
Type of service:	Residential Business
Service Plan:	Smart Choice Basic
If you choose Basic Service, please indicate any Options you would like to add (Control+Click to select multiple items)	Voice Mail Call Waiting Caller Number ID Caller Name & Number ID Anonymous Call Rejection Automatic Call Back Call Forwarding Distinctive Ringing Selective Call Acceptance Selective Call Rejection Speed Dialing Three-way Calling Remote Call Forwarding
Number of lines needed:	1 2 3 4 5 6+
Will you be keeping your current phone number(s)?	Yes No
If you are keeping your current phone number(s), please list all numbers:
Have you ever had phone service from Globe?	Yes No
Are you a current Newnan Utilities customer?	Yes No
Who is your current local/long distance provider?
Questions or comments: