APS Letter of Authorization
(Dial Around Service)
Personal Information
Account Type:
Residential
Business
Contact Name:
Company Name:
(if business account)
Date of Birth:
(mm/dd/yyyy)
Log In Password:
(APS Web Site)
E-mail:
Physical Address
Address:
City:
State:
Zip:
Mailing Address (if different from above)
Address:
City:
State:
Zip:
Billing Options
Mail
E-mail
Dial Around Sign Up
Primary Phone:
Phone Number 2:
Phone Number 3:
Phone Number 4:
Phone Number 5:
