Referral Form

The friend that is signing up for service needs to fill out the Referral Form. You will receive a $10 credit for each qualifying service you sign up for, up to a $30 credit.
The person who referred you will receive a $15 credit for each qualifying service you sign up for, up to a $45 credit.

YOUR Name:
Street Address:
City:
State:
Zip:
Home Phone Number:
I Am Signing Up For
The Following Services:		  Digital TV
  DSL High-Speed Internet
  Telephone

HickoryTech Customer
Who Referred You:
Their Address:
City:
State:
Zip:
Home Phone Number:


Terms and Conditions:
1. The person you refer must live within HickoryTech service area.
2. To qualify as a new customer, the person referred must not have had the HickoryTech service they were referred for within the past 90 days, and must have no outstanding obligation to HickoryTech.
3. Credits will be applied to each customer's bill after the person referred signs up for HickoryTech service and the installation is complete. Credit will appear on bill 90 days after installation is complete.
4. The friend that is signing up for service needs to fill out the Referral Form online or pick up a Referral Form at HickoryTech or call HickoryTech to give the referral information over the phone.
5. The friend can only enter one customer name as the person that referred them. One referral per friend.
6. HickoryTech employees are not eligible for referral program.
7. Referral Program is subject to change. Other restrictions may apply.