ECTC Fiber SignUp form ECTC Fiber SignUp It's time to build your Fiberhood! Sign up today to receive your ultimate Internet upgrade! First Name * Last Name * Title Mr. Ms. Mrs. Dr. Jr. Date of Birth Primary Phone Number * Secondary Phone Number Work Phone Email (All correspondence including your service agreement, installation scheduler, and billing information will be sent to this email address.) * Spouse's Full Name (if applicable) Spouse's Email * Service Address * City * State * Zip * Is your billing address different from your service address? * Yes, they are different. No, they are not. Billing Street Address * Billing City * Billing State * AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Billing Zip * Your Fiberhood Are you currently an existing customer? * Yes I'm a current Customer No, I am not a current customer Do you rent or own the property where you are looking for service? * Rent Own Landlord Name * Landlord Email Landlord Phone Number * Available Bundles Bundle Packages * PackageServices includedMonthly Price Standard TV Telephone, Emily Digital Choice, Subscriber Line Charge$83.95 Choice Telephone, High Speed Internet (Speeds up to 20M Down/10M Up), Emily Digital Choice, Subscriber Line Charge$115.95 Entertainment Telephone, Emily Digital Advantage, Emily Digital Music, Voice Mail, Caller/On-Screen Display, Subscriber Line Charge$123.95 Advantage Economy Up to 40/20M High Speed Internet, Telephone, Voice Mail, Subscriber Line Charge, Digital Advantage Economy, Digital Music, Caller ID/On-Screen Display$141.20 Advantage Up to 40/20M High Speed Internet, Telephone, Voice Mail, Subscriber Line Charge, Digital Advantage, Digital Music, Caller ID/On Screen Display$141.20 Elite Economy Up to 60/30M High Speed Internet, Telephone, Voice Mail, Subscriber Line Charge, Digital Elite Economy, Digital Music, Caller ID/On-Screen Display$149.20 Elite Up to 60/30M High Speed Internet, Telephone, Voice Mail, Subscriber Line Charge, Digital Elite, Digital Music, Caller ID/On-Screen Display$158.95 No Thank You Upgrade your bundled Internet Speed options! * 20M/10M to 40M/20M $10 more/month 40M/20M to 60M/30M $10 more/month 60M/30M to 90M/60M $10 more/month No Thank You **Speeds not guaranteed in all areas. Internet Details Internet with Phone Service * PackageInternet Package SpeedsMonthly Price Internet Choice Up to 20.0M/10.0M$79.95 Internet Advantage Up to 40.0M/20.0M$89.95 Internet Elite Up to 60.0M/30.0M$99.95 Internet Elite Plus Up to 90.0M/60.0M$119.95 Internet Gig Up to 1 GIG/100M$174.95 No Thank You **Includes all applicable phone charges, except sales tax, FUSC charges, any calling features and long distance. Speeds not guaranteed in all areas. Standalone Internet Options * PackageMonthly Price 100 Mbps / 100 Mbps $89.95/month No Thank You *Speeds not guaranteed in all areas. Static IP Address $5.00 per Total number of 7' Ethernet Cable(s) $6.50 + Tax per unit Total number of 14' Ethernet Cable(s) $11.49 + Tax per unit Managed Wi-Fi & Router - $6.95/month TV Details Premium Channel Packages One month minimum charge on packages. Prices do not include applicable taxes and regulatory fees. HBO Premium Channels $20.95/month Cinemax Premium Channels $13.95/month HBO/Cinemax Premium Channels $27.95/month Starz/Encore Premium Channels $13.95/month Showtime Premium Channels $20.95/month High Definition options Advantage and Elite HD $9.95/month Choice HD $3.95/month Digital Video Recorder (DVR) Digital Video Recorder (DVR) $9.95/month Additional Set Top Boxes - $4.95/Mo per box First Box is Free Internet Details *Internet speeds will reflect best available speed "up to". Customers will receive our fastest available speed to your home. Static IP Address $5.00 per Managed WiFi - $6.95/Mo Upgrade to a Gig Service - $100.00/Mo Extra Voice Details Custom Calling Features(The charge is $2.50 per month for each feature unless marked otherwise)*Call Trace is automatically on all lines and is billed at $1.00 per completed trace. Call Waiting Speed Dialing - 8 numbers Speed Dialing - 30 numbers ($3.00) Caller ID Preferred Call Forwarding Call Screening Special Call Acceptance Caller ID/Call Waiting ($6.00) Caller ID w/Name ($5.50) Telemarketing/Do Not Disturb ($3.50) Call Forwarding- (fixed or variable) Three Way Calling Call Transfer Priority Ringing Call Return Repeat Dialing Remote Active Call Forwarding Toll PIN Control ($3.50) Caller ID w/Name-Call Waiting ($8.50) Do you wish to have an 800 number? Yes Do you request an unlisted number or non-pub number? unlisted number non-pub number Do you wish to have Voice Mail? Standard ($3.50, 2 minutes per message, 20 messages) Standard Plus ($4.50, 3 minutes per message, 30 messages) Premium ($6.50, 3 minutes per message, 40 messages) Voice mail to e mail alert $1.50 per month No Thank You Do you want Long Distance capabilities? Yes The ability to call 800 numbers only? Yes Bill Payment & Additional Options E-Mail Account information - if Requested Username (4-20 characters) Password ( 8 char. Min.) Your Password must contain at least 8 charactersSelect a combination of letters or numbers that ONLY YOU can remember. Bill Pay Options * eBill PaperBill Plow Charges: $200 charge up to 300ft $350 Up to 750 feet $700 Over 750 feet up to 1,500 feet Any drops over 1,500 feet will be bid. * Yes, I have read the above Plow Charges and am aware that I will be responsible for any charges upon install. Plow Charges: One-time plow charge of $200. *Customers will receive our fastest available speed to your unit up to 100 Mbps. **Must subscribe to either Choice TV, Advantage TV or Elite TV to add High Definition TV. HDTV programming based on programming tier choice. Digital IPTV is not offered as a stand alone service, it must be taken with either High Speed Internet or land line phone service. Minimum of 4 months of service required. * Yes, I have read the above Plow Charges and am aware that I will be responsible for any charges upon install. How did you hear about us? * Email Community Event Direct Mail Facebook Employee Service Truck Referred by a friend/neighbor Web Advertisement Web Search Other To assist our construction crew, please list any fences or buried facilities (geothermal lines, sprinkler system, etc.) on your property that would not be found during a Gopher One Call locate. Any comments or additional information that we should be aware of? Text Email reCAPTCHA Submit
