sm_logo.gif (1184 bytes) Access America Telephone Company

Request for a Written Proposal for Telephone Services

Form Submitted By:
(Please enter the name to be used as the contact person for this account)

Business Name and Address Information:
(Please enter the name and address for the business, this should be a physical address)
Business Name:
Street Address (cannot be a P.O. Box):
Street Address, line 2:
(Note:  Local Telephone Service is not currently available in VA)
Zip Code:
Contact's Telephone Number: (Format XXX-XXX-XXXX)
Contact's FAX Number: (Format XXX-XXX-XXXX)
Contact E-Mail Address: (
Best Time to Call: (i.e. mornings, afternoon, Mondays, Fridays, etc.)
Tell Us About Your Business:
Nature of your business:
(Please briefly describe what your business does)
Current Long Distance Carrier
Current Local Telephone Co.
1+ Long Distance
Minutes of Use
Monthly Fee
800 Inbound Calling
Minutes of Use
Monthly Fee
Calling Cards
Local Telephone Service
Number of Telephone Lines
Quantity and Type of Lines
Quantity and Type of Lines
Quantity and Type of Lines
Describe your local telephone services (types of lines and features such as hunting, call waiting, call forwarding, voice mail, etc.):

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Access America
673 Emory Valley Road
Oak Ridge, Tennessee  37830

Copyright 1996-2015
Last Updated:  March 6, 2015