New Service Order Form

Services:

Internet/Phone Only Bundles:

High Speed Internet Upgrade (a la carte):

High Speed Internet requires installation/activation fees. Our staff will provide additional details. *Prices shown are with active telephone service. *Download and upload speeds may vary.

Telephone:

Calling Features:

Long Distance:

Yes
No

Inside Wire Maintenance:

Yes - $2.75/Mo
No

Cable TV Services:

Television services requires installation/activation fees. Our staff will provide additional details. **Requires digital cable service. ***Requires digital service and set top box.

Movie Channels:

Wi-Fi Home Solutions:

Additional Products & Services:

Connect Protect AntiVirus (Monthly Package) - $2.99/mo. (covers up to 3 devices) $1.25/mo for each additional device
Connect Protect AntiVirus (Yearly Package) - $29.99 for 1-year (covers up to 3 devices) $1.25/mo for each additional device
Static IP Address - $10.00
Modem Warranty - $2.00/mo

Security Solutions with Connect Secure:

Residential Package: $29.95/mo
Business Package: Call for Pricing

Account Information:

Name: *

First

Last

Phone Number: *

Email: *

Address: *

Address Line 1

Address Line 2

City

State

Zip Code

Billing Address (If Different Than Residential): *

Address Line 1

Address Line 2

City

State

Zip Code

Enter Promo Code:

*For Promotional discounts.

How Did You Hear About Us?

Enter Your Birthday for Coupons and Discounts!

MM/DD/YYYY

RTC New Service Form

Services:

Account Information:

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