My Services
BILLING APPLICATION FOR COMPUTER REPAIR SERVICES
@{ form.errors.get('organizationName') }
@{ form.errors.get('authorizedPerson') }
@{ form.errors.get('phoneNumber') }
@{ form.errors.get('email') }
@{ form.errors.get('billingAddress') }
@{ form.errors.get('billingCity') }
@{ form.errors.get('billingState') }
@{ form.errors.get('billingZip') }
@{ form.errors.get('taxExempt') }
Include Certificate if Exempt
@{ form.errors.get('existingCustomer') }
@{ form.errors.get('accountNumber') }
@{ form.errors.get('bill') }
@{ form.errors.get('shippingAddress') }
@{ form.errors.get('shippingCity') }
@{ form.errors.get('shippingState') }
@{ form.errors.get('shippingZip') }

Security Q&A

@{ form.errors.get('securityQuestion') }
@{ form.errors.get('securityAnswer') }

Authorized Personnel

I give the following people listed here the authorization to make changes / inquiries to our Paul Bunyan Communications Account. I understand that these people will need to know the security answers to make changes / inquiries. I also understand that it is my responsibility to notify Paul Bunyan Communications of any changes to the Authorized Persons list.
@{ form.errors.get('authorizedPersonnel') }
@{ form.errors.get('signature') }
I agree that any transactions or agreements with Paul Bunyan Rural Telephone Cooperative dba Paul Bunyan Communications or its associated companies may be formed by electronic means.
@{ success }
@{ error }