Residential Account Applications - Volcano Communications

Date of Birth(Required)

DL/Gov't ID# (Include copy)(Required)

Last four of SSN(Required)

Contact phone #(Required)

Email(Required)

Phone(Required)

Address

Landlord phone(Required)

Co-Applicant Information

Contact phone(Required)

Email(Required)

Date of birth(Required)

DL/Gov't ID#(Required)

Last four of SSN(Required)

Employer name(Required)

Phone(Required)

Address(Required)

Customer Proprietary Network Information (CPNI) Additional Authorized Contacts

***All Contacts, including the Account holder and Co-applicant, must know the account password to discuss an account. Please create a password below***

Contact name(Required)

Phone(Required)

Date of birth(Required)

Contact name

Phone

Date of birth

Password to Access Account/Security Questions *at least two, please

Account password:(Required)

Hint:(Required)

First pet's name(Required)

First car(Required)

Favorite team(Required)

Credit References/Nearest Relative

Name(Required)

Phone(Required)

Relationship(Required)

This application is submitted to obtain services and I/we certify that all information is true and complete. I/we authorize Volcano Communications Group (VCG) to verify or obtain further information that it may deem necessary concerning my/our credit standing. If this information is not complete or is untrue, I/we agree that service may be denied or discontinued. If this application is approved and service provided, the undersigned agree to pay for all services rendered. I, the undersigned, am authorizing VCG to act as my representative to place a service order and to exchange information as necessary with VCG Affiliates. I/we have read and agreed to the terms and conditions of the service agreement.

By checking the box below, I acknowledge that I have read and agree to the Volcano Communications Group Subscriber Privacy Policy and Network Agreement. You may obtain a printed copy of these policies from the VCG Business Office, located at 20004 Highway 88 in Pine Grove, CA, or Online at: www.volcanocommunications.com/privacy-policy

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