Date:
*Installation Date:
*Contact Phone:
*Business Name:
Tax ID#:
*Service Address:
*Billing Address:
*Type of Business:
*Accounts Payable Contact:
Publish in directory (unlisted $2.00 month)
Yes
No
As a business customer you are entitled to ONE FREE regular listing in the yellow pages.
Catergory for Yellow Pages:
List As:
Additional Listing ($1.35/month):
Please select Calling Features (charges are monthly):
900 Call Block ($0.00)
Collect Block($0.00)
Bill to 3rd No. ($0.00)
Call Waiting ($1.50)
Call Forwarding($1.50)
3 Way Calling ($1.50)
Cancel Call Waiting($1.50)
Teen Line ($1.50)
Speed Dial 8 ($1.50)
Call Forward Busy ($3.00)
CFW No Answer ($3.00)
Automatic Call Back ($3.00)
Caller ID($7.50)
Speed Call 30 ($3.00)
*Inside Wire Maintenance Program ($1.95/month)
Yes
No
*Please choose a long distance carrier from the list below for INTERLATA calls. For questions, please
contact the appropriate long distance carrier. Contact information can be found to the right under "Additional
Kansas Information"
No PIC - 9999
Excel Communications -0752
WESTEL, Inc. -0085
Global Crossing -0444
MoKan Communications -9050
MCI WorldCOM -0222
Sprint Communications -0333
AT&T Communications -0288
Qwest Communications -0432
Broadwing Telecom -0071
SBC -5792
*Please choose a long distance carrier from the list below for INTRALATA calls. For questions, please
contact the appropriate long distance carrier. Contact information can be found to the right under "Additional
Kansas Information"
No PIC -9999
MCI WorldCOM -0222
Verizon Select Serv -5483
WESTEL, Inc. -0085
SBC -5792
Matrix Telecom -0780
Sprint Communications -0333
UNIDIAL -5957
Excel Communications -0752
EMERITUS -0457
AT&T Communications -0288
Global Crossing -0444
MoKan Communications -9050
Broadwing Telecom -0071
Qwest Communications -0432
If you have selected MoKan as your Long Distance carrier, please select from one of the following calling plans
Please Choose One Option
Block of Time Plans**
If you have selected MoKan as your Long Distance carrier, please select from one of the following calling plans
Please Choose One Option
Block of Time Plans**
$4.00/One hour and $.08 per additional minute
$40.00/25 Hours and $.08 per additional minute
$25.00/15 Hours and $.08 per additional minute
Flat Rated Plans
$5.95 Monthly Fee $.05 per minute
$3.95 Monthly Fee $.10 per minute
No Monthly Fee, $.15 per minute
***Block of Time Plans are for “Intralata” direct dialed calls. For Hillsdale & Louisburg customers this would be calls to 913, 816, or 660 area codes. Rantoul customers Intralata calls are to the 785 area code. Calls to Internet Service Providers do not qualify for discount. Flat rated Plans are calls anytime within the 48 contiguous United States. Calls to Internet Service Providers do not qualify for discount
If your current long distance carrier does not appear on the above list, please contact them
for service. It is the responsibility of each individual to notify the carrier of choice to
initiate service.
Directory Assistance (411) is available to all customers of Mokan Dial, Inc. $1.00 per call, 2 listings per call.
Call completion is available for an additional per minute rate.
We offer pre-paid and regular calling cards. Prepaid cards are available for under $.04 per minute. Regular
cards are $.20 per minute plus a $.50 per connect charge.
Internet Service is provided to customers of Mokan Dial, Inc. through MoKan Communications, Inc.
Dial-up Service is available to all customers of MoKan Dial, Inc. High Speed (DSL) is available to most customers
limited by distance from Serving Wire Center Equipment. A seperate application is required for Internet Service
Dial up or DSL. No length of service required for Dial-Up. Service charges to activate DSL are waived if a one year
contract is signed. All necessary forms can be found at our menu to the right, or at the Mokan Communications website.
By clicking the submit button I understand and agree to the following statement: The undersigned makes application
for the above service and agrees to pay established rates for such service. In making this application the Undersigned agrees to
the rules and regulations of MoKan Dial, Inc. as set forth in the Exchange Tariff and in any changes in the rules, regulations, tariffs or rates
for the service furnished under this application. The Undersigned also understands if additional lines are added in the future,
and if one line is disconnected for payment purposes, the other lines may also be suspended. The undersigned is responsible for any and all
long distance charges made from or charged to this account. Monthly rates listed above do not include sales tax.