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Contact Information
Customer Information

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Married Single
Divorced Widowed

Own Rent
Employment Information

Spouse or Co-Responsible Adult
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Nearest Relative:

Local Telephone Service
$15.95 - Does not include regulatory charges, taxes, and other surcharges
Directory Listing
Automatic Bank Account Charge Authorization
Choose Desired Options
Published Free (Available from Directory Assistance and Brandenburg Directory)
Non-listed $1.50 Per Month (Available from Directory Assistance, not published in Brandenburg Directory )
Non-published $2.00 Per Month (Not available from Directory Assistance nor Brandenburg Directory)
No (Free)
Yes ($ 2.95)
Voice Mail/Call Answer Service
10 minutes $5.00
20 minutes $6.00
30 minutes $7.00
Number of Rings
10 minutes $7.50
20 minutes $8.50
30 minutes $9.50
Number of Rings
10 minutes $10.00
20 minutes $11.00
30 minutes $12.00
Number of Rings
30 minutes $20.00
Number of Rings
Class Services:
(1) Teen Service - $3.95
(2) Automatic Call Back - $4.50
(3) Automatic Recall - $4.50
(4) Calling Number Delivery - $7.00
(5) Dialable Number Delivery - $7.50
(6) Calling Number/Name Delivery - $7.50
(7) Dialable Number/Name Delivery - $8.00
(8) Call Block - $4.20
(9) Distinctive Ringing/Call Waiting - $6.00
(10)Selective Call Forwarding - $4.20
(11) Avoid-A-Call - $4.20
(12) Anonymous Caller Rejection - $1.00
Speed Calling 8 - $2.95
Speed Calling 30 - $3.50
Call Waiting - $2.95
Three Way Calling - $2.95
Call Forwarding - $2.95
Brandenburg Telephone Residential Plan ($0.15/minute with no service fee)

Brandenburg Telephone Home Plus Plan ($0.10/minute, $ 3.95 per month)

Other Carrier, please name:

Yes No
It is your responsibility to contact your carrier if choosing a provider other than Brandenburg Telephone Long Distance. These long distance charges may not appear on your local phone bill. We will make every effort to ensure that your telephone service is connected to the Long Distance Company you choose. In the event your service is inadvertently connected to a different company, we will assume liability only to the extent of connecting your chosen company at the earliest opportunity after you notify us.
Digital Video
DV-Basic - (DVB) $17.95

DV-Deluxe - (DVD) $66.95

DV-Gold - $86.85

No Package
DVR - Digital Video Recorder for $12.95
Whole Home Digital Video Recorder $17.95
HD Digital Video Recorder $19.95
Whole Home HD DVR $24.95
Sports Pack - $9.95

Family Pack - $11.95

HD Deluxe - HD Local plus the following channels for $10.95

Movie Channels
Cinemax with More MAX, Action MAX, Thriller MAX, @MAX, W MAX, Outer MAX, and Star MAX Channels. - $17.95

Home Box Office with HBO2, HBO Plus, HBO Signature, HBO Family, HBO Comedy, HBO Zone and HBO Latino Channels. - $20.95

Showtime with Showtime 2, Showtime Beyond, Showtime Extreme, Showtime Showcase, Showtime Next, Showtime Family, Showtime Woman, Movie Channel, Movie Channel Xtra, and FLIX - $19.95

Starz with Starz Edge, Stars Kids & Family, Starz In Black, Starz Cinema, Starz Comedy, Encore, Encore Wam, Encore Action, Encore Love, Encore Mystery, Encore Drama, Encore Westerns - $16.95

Cinemax and HBO Packages - $37.95

Cinemax and Showtime packages - $37.95

HBO and Showtime Packages - $37.95

Cinemax and Starz/Encore - $37.95

HBO and Starz/Encore - $37.95

Showtime and Starz/Encore - $37.95

HBO, Showtime and Starz/Encore - $51.95

Showtime, Starz/Encore, Cinemax - $51.95

HBO, Cinemax, Showtime - $51.95

HBO, Cinemax, Starz - $51.95

All Four Channels - $63.95

No Movie Package
Adult Programming also available upon request. Please contact our office for more details.
Internet Services
Rates listed below are for copper areas. In fiber served areas, speeds are faster than those listed for copper.
Up to 5/1 Meg

Without DV-Deluxe/ Gold Package - $39.95/month
With DV-Deluxe/Gold Package - $34.95/month

Up to 10/1 Meg

Without DV-Deluxe/ Gold Package - $49.95/month
With DV-Deluxe/Gold Package - $44.95/month

Up to 20/1 Meg

Without DV-Deluxe/ Gold Package - $59.95/month
With DV-Deluxe/Gold Package - $54.95/month

E-mail: Enter your username and password for your BBTEL E-mail address. Your e-mail address will be your - Optional.
If left blank, and selecting any internet plan, we will contact you for this information.
Yes No
Your estimated installation charges, 1 month charge on Digital Video and/or DSL and deposit (if required) must be paid prior to installation. Our office will contact you to discuss applicable charges prior to installation.