Online Application for Wireless Service
We require certain information to process your order and complete the mandatory credit check for all new service activations. The information you provide on your Application for Wireless Service is used solely to verify credit and to establish your new wireless service account.

Applicants who do not meet our credit requirements may be asked to pay a deposit before we can establish service. If a deposit is required, you will receive written notification via U.S. Mail, telephone call, or email regarding the deposit remittance. Alternatively, you may choose to prepay for wireless service. Prepaid wireless service is available for purchase at your Barr Rich Appliances. Prepaid service does not require a credit check.



Customer Information - Please use name in which your credit has been established.
(Mr., Ms., Dr., etc.):
First Name:
Middle Initial:
Last Name:
Suffix: (Jr., Sr., III, etc.):
Home Phone:
(###-###-####)
Work Phone:
(###-###-####)
Social Security Number:
Driver's License Number:
Driver's License State:
Date of Birth: / /
(MM/DD/YYYY)
Gender: Male
Female
Email Address:


Service Address - Enter the address where you would like service to be assigned.
Address 1:
Address 2:
City:
State:
Zip Code:


Billing Address - Enter the address where you would like to be billed. Skip this section if Billing Address is same as Service Address.
   
Address 1:
Address 2:
City:
State:
Zip Code:


Payment Information and Shipping Address - Please enter your name and the address where you would like the phone and service agreement to be shipped. You may also pick up your equipment at Barr Rich Appliances, Inc.

Your name and shipping address must match the billing address
of the credit card you are using to purchase your equipment.
Name:
Address 1:
Address 2:
City:
State:
Zip Code:
Credit Card:
Account Number:
Expiration: Month Year


If you meet our credit requirements, you will receive a bill each month for your wireless service. If you do not meet our credit requirements, your credit card will not be charged for the cost of the phone.

If the information above is correct, select the "Submit My Order" button. This will confirm your order and acceptance of Barr Rich/Cellular One's Terms and Conditions of Service.

To cancel your current order, select the Cancel My Order button.

 

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