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Application
All fields are required
except where noted
Personal Info
First Name
Last Name
Street Address
Street Address 2
(optional)
City
St
Zip
Home Phone
000-000-0000 format
Work Phone
000-000-0000 format
E-Mail Address
Prison & Inmate Info
Prison Facility Name
City and State
Prison Phone Number
000-000-0000 format
Inmate’s Name
Inmate’s relationship
to you (optional)
Choose...
Mother
Father
Wife
Husband
Sister
Brother
Grand Mother
Grand Father
Friend
Fiance
Other (--->)
other:
Current Long Distance Info
How much do you spend each month on collect calls?
Choose...
$0 - $50
$51 - $100
$101 - $150
Over $150
How much is each
prison call now?
dollars per
Choose...
10 minute
15 minute
20 minute
30 minute
call
How did you find out about Tele_net's Phone Service?
How did you find about us?
Choose...
Print Ad
Web Banner/Ad
Web Search Engine
Referral
Other (--->)
other:
*The above information will only be used by our company to provide a quotation to you for our Inmate Calling program. Completing this quotation application does not obligate you to purchase anything. You will receive a quotation via email to the address provided above, along with an application that must be returned with a signature for service to be started.