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All fields are required
except where noted
Personal Info
First Name
Last Name
Street Address
Street Address 2
(optional)
City
St
Zip
Home Phone
000-000-0000 format
Work Phone
000-000-0000 format
E-Mail Address
Prison & Inmate Info
Prison Facility Name
City and State
Prison Phone Number
000-000-0000 format
Inmate’s Name
Inmate’s relationship
to you (optional)
Choose...
Mother
Father
Wife
Husband
Sister
Brother
Grand Mother
Grand Father
Friend
Fiance
Other (--->)
other:
Current Long Distance Info
How much do you spend each month on collect calls?
Choose...
$0 - $50
$51 - $100
$101 - $150
Over $150
How much is each
prison call now?
dollars per
Choose...
10 minute
15 minute
20 minute
30 minute
call
How did you find out about OCS PrisonCalls Phone Service?
How did you find about us?
Choose...
Print Ad
Web Banner/Ad
Web Search Engine
Referral
Other (--->)
other:
*The above information will only be used by our company to provide a quotation to you for our Inmate Calling program. Completing this quotation application does not obligate you to purchase anything. You will receive a quotation via email to the address provided above, along with an application that must be returned with a signature for service to be started.
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