Residential Service Application - Warm Springs Telecom

Online Application

Fill out the form below to apply for residential service. All fields marked with * are required.

Full Name *

Phone Number *

Email Address *

Date of Birth *

Social Security Number (Last 4 digits) *

Street Address *

City *

State *

ZIP Code *

Same as service address

Street Address

City

State

ZIP Code

Select Services: *

Internet Service Phone Service Long Distance

Preferred Internet Speed

Requested Installation Date

Additional Comments or Special Requests

I agree to the Service Agreement and Privacy Policy *

I authorize Warm Springs Telecom to check my credit *

Applications are typically processed within 1-2 business days. We'll contact you to confirm your installation date and schedule a technician visit.

A deposit may be required based on credit check results. Installation fees apply. Contact us at (541) 615-0555 for current rates.

Prefer to fill out a paper application? Download and print our PDF application form:

Download PDF Application

Hours: Mon-Fri 8:30am-4:30pm