Service Application | Hillsboro Telephone Company

Service Application

You have two options for filling out a service request.

Download the application using the button
Fill out the online form below.

When we receive either form from you, we will be in contact soon to complete your service request.

If you have any questions, you can contact us for assistance.

Download Service Application

Online Service Application

Step 1 of 5

Residential Internet Service

Business Internet Service

Additional Internet Options

Leased Router - $ 6.00

An internet router is required when connecting more than one computer or internet enabled device to the Broadband Internet service.
Some restrictions apply. Equipment purchase may be required.

If the customer chooses not to purchase their own WIFI router, the customer may lease a WIFI router from Hillsboro Telephone Co. and have access to a managed WIFI app and support from Hillsboro Telephone Co. for the leased WIFI router.

See our “INTERNET SERVICE CUSTOMER AGREEMENT” on our policies page for more details.

Telephone Service

Telephone Long-Distance Plan

Plan 1: Direct Dialed 1 + domestic calling to interstate or intrastate locations ($0.15 per minute) - $ 0.00
Plan 2: Direct Dialed 1 + domestic calling to interstate or intrastate locations ($0.10 per minute) - $ 4.95

Continental U.S. only excluding Hawaii and Alaska.
$.15 per minute for Hawaii, Alaska, U.S. Virgin Islands, Puerto Rico, Guam, Northern Mariana Island (Saipan).

IP TV Service

Additional IP TV Options

Additional Set-top Unit - $ 7.00
Digital Video Recorder (DVR) Service - Pause, Rewind, Replay and Record Live TV and Shows. - $ 3.50

Movie Packages

Cinemax - $ 8.00
HBO - $ 17.50
Showtime - $ 12.95
Starz - $ 13.60

Receive a $29.95 discount on internet service when bundling your IPTV and internet service. Please use the service calculator tool on the home page to create your service package. (requires one of the above video services)

OTHER NON-RECURRING CHARGES
Video License Fee $55.00
Service Activation Charge $25.00

Estimated Monthly Payments

$ 0.00

Taxes and other regulatory fees may apply. See our "Video Service Customer Agreement" on our policies page for more details.

Billing Information

Applicant's Name *

First

Last

Co-Applicant's Name

First

Last

Business Name (if signing up for Business Service)

Current Address *

Address Line 1

Address Line 2

City

State

Zip Code

Previous Address

Address Line 1

Address Line 2

City

State

Zip Code

Primary Phone *

Work Phone

Cellphone

Do you allow the Company to contact you via email? (Please mark one)

Billing Policy

Hillsboro Telephone (services provided by Hillsboro Telephone Company) and Verneau Networks, Inc. (where applicable) provides a combined monthly statement; all services will be in one billing statement. On the first page of the statement, there will be a total for each service and a combined total. The details for each service will be on the subsequent pages. Unless otherwise specified by you, your payment will be applied in the following order (as applicable): 1) Hillsboro Telephone Company; 2) Verneau Networks and are due on or before the 15th of each month.

Any bills not paid on or before the 15th will be considered past due and will be assessed a past due charge of $25.00 per billed account. Past due bills not paid on or prior to the 20th of the month will be subject to disconnection for nonpayment. Disconnected accounts must be paid in their entirety prior to being reconnected and will be assessed a $50.00 reconnection fee in addition to the past due balance and late fees. Disconnection notices are only applicable to telephone services and apply only to that portion of the billing statement and will only be sent to customers that have telephone services.

Account Payment Options

** All monthly payments (regardless of payment method) are due by the 15th of each month. **

Option 2:
SmartHub Online payment method (e-checking or credit card)
SmartHub is our online payment method which has several features that make managing your account as easy as possible. Whether through the web, on your smartphone or tablet (Android or iOS), you’ll be able to pay your bill, view your past billing history, contact customer service and get the latest news.

Making payments through SmartHub is fast and easy. The first time you make a payment either through the web or through your mobile device, you’ll be able to securely store your payment information for future transactions. The next time you need to pay your bill, it will only take a couple of clicks.
Hillsboro Telephone must first create your account number for you to register with SmartHub. You will receive an email invitation to set up your payments once we add your account to our billing system.

Option 2:
Automatic Payment (ACH) Funds are transferred electronically from one bank account to another. Funds will be debited from your checking account and credited to our account on the 10th of each month. You will still receive a monthly statement by mail unless you have changed this in Smarthub by selecting the paperless bill option in which case you will be notified by text or email when your bill is available to view online. This is how you will know what funds are being debited from your checking account each month. There is no cost to you for using this method of payment. If you would like to use this method of payment, please check the box below and return the attached ACH form to our office by postal mail, or by placing it in our drop box at the office located at 121 Mill St., Hillsboro, WI.

Option 3:
Paper mailed statements and pay by mail or drop box with check or money order. If you do not choose to use any method of electronic payments, you may still use traditional mailing of monthly payments. Monthly statements are mailed the first of each month, and payment is due by the 15th of each month. Please mail your payment by the 10th of each month so we receive

Payment Option Selection *

Option 1 - Smarthub Credit/E-Check
Option 2 - Automatic Payment (ACH)
Option 3- Paperbill - Check or Money Order

To ensure compliance with the Customer Proprietary Network Information (“CPNI”) rules of the Federal Communications Commis-sion, codified at 47 C.F.R. Part 64 Subpart U, implementing Section 222 of the Communications Act of 1934, as amended, the Company must seek the customer’s approval or disapproval to use, disclose, or permit access to the customer’s CPNI for marketing of additional services by its affiliates and business partners.

Do you allow the Company to share your account information with its affiliates for marketing of additional services and offers? (Please mark one) *

Do you allow the Company to share your account information with its business partners for marketing of additional services and offers? (Please mark one) *

Authorized Users

I/we fully understand that I/we am/are fully responsible for the payment on this/these account(s), I/we am/are also authorizing the following person(s) to have access to the account(s) and make changes on my/our behalf.

Authorized User 1 Name

Authorized User 1 Phone

Authorized User 2 Name

Authorized User 2 Phone

DISCLOSURE AND AUTHORIZED USERS RESPONSIBILITY

The Hillsboro Telephone company and Verneau Networks are equal opportunity service providers and do not unlawfully discriminate on the basis of race, sex, age, religion, national origin, marital status, veteran status or any other basis prohibited by federal, state or local law.

I/we certify to the truth of my/our statements, that the above information is true and accurate and I/we authorize Hillsboro Telephone Company or Verneau Networks, Inc. to obtain a credit report in connection with this application, update, renewal and extension thereof. Upon request, I/we will be informed of the bureau name and address.

I/we fully understand that by signing this application, I/we am/are fully responsible for payment of the bill for service(s) and am/are authorized to make changes to the account(s). I/we fully understand that without a signature from the co-applicant that the co-applicant as well as those that I/we may have listed as authorized users are authorized to access and make changes to the account.

I HEREBY CERTIFY THAT:
1. The credit information I provide is true and correct.
2. The services I select are those I have requested.
3. I agree to the rules, regulations, and tariffs under which the Hillsboro Telephone Company operates and to any changes as may be approved by State or Federal Regulatory bodies.

The undersigned makes application for service of the kind and class as described in the application and agrees to pay the rates established for such services. The undersigned further agrees to the rules and regulations as set forth in the exchange tariff, and to any general changes in the rules, regulations, tariffs or rates for such service.

This application becomes a contract when accepted by the Hillsboro Telephone Company.

When you click the submit button below, our team will receive your request for service.

Someone will reach out to you via your preferred method of contact indicated below. If you have any questions, you can send an email to info@hillsborotel.com or calling (608) 489-3230.

Preferred Method of Contact (Check all the apply) *

Direct Mail
Phone
Email

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