Application

Account Information
Full Name*
Service Address Street*
City/State/Zip*
Cell Phone*
Alt Contact Name
Alt Contact Phone Number
Is your billing address different than your service address?

YesNo
Billing Address - Name
Billing Address Street
City/State/Zip
How would you like to receive your monthly GTC Broadband statement?

EmailPaper Statement
If you choose Email, your GTC Broadband statement will be sent from Donotreply@ebillnotify.com. Please make sure to add this address to your e-mail account's safe sender list or be sure to check your spam filter. Additionally, if you enroll in Autopay on our website, you may receive a second notice of bill readiness. If you have questions, please contact our office.
Email*
When is the best time to call?*

MorningAfternoon
How would you like to pay your monthly statement?

AutoPay (recommended for timely payment every month)I'll schedule an automatic payment on the website. (If you choose this option, payment schedule cannot be set up until after you receive your first statement because you will need your account number to create the payment)Paper bill, I'll send a check in the mail.(Bills are due upon receipt, late after the 21st and subject to disconnect the last day of the month)
Activation Charge & First Month Service Fee
A minimum, nonrefundable Activation/Installation fee of $150.00 and the first month's service are collected in advance.
Please initial to accept the above statement*
Structure where service is to be provided?

Single Story HouseTwo Story HouseModular HomeMobile Home-Trailer HomeApartment ComplexDuplexOther
Any changes to the property that might be helpful to know prior to onsite visit Remodel new siding etc
Do you own this property?

YesNo
Property owner's approval may be required if construction is needed.
Choose Your Services
Services

Internet OnlyTelephone OnlyInternet with Phone
Internet Only

25 Mbps - $79.00 per month100 Mbps - $89.00 per month250 Mbps - $99.00 per month500 Mbps - $129.00 per monthGigabit Plan - $189.00 per month
Internet with Phone

25 Mbps - $79.00 per month100 Mbps - $89.00 per month250 Mbps - $99.00 per month500 Mbps - $129.00 per monthGigabit Plan - $189.00 per month
Support And Maintenance Plans
Support And Maintenance Plans

Standard Managed Wi-Fi (no additional charge) – This Wi-Fi service broadcasts a Wi-Fi signal to blanket most standard sized homes/ home businesses with full Wi-Fi connectivity. (Download the GTC WiFi app from the apple store-Search for GTC WiFi)Complete Connect + Protect ($8.95 per month) – included with 250Mbps plan and above - This Wi-Fi service increases the broadcast signal of the standard Wi-Fi to reach areas outside of the standard Wi-Fi capability. May be required for large homes, two-story homes, homes with basements and/or to reach outdoor living areas. This is intended to enhance the Wi-Fi signal and is not a solution for outside buildings, barns, or garages. (Additional equipment may be required) (Download the GTC WiFi app from the apple store-Search for GTC WiFi)
Acceptable Use Policy
Click here to read our Acceptable Use Policy.
By checking this box, you acknowledge and agree to the terms outlined in GTC Broadband's Acceptable Use Policy.*

I agree
Customer Information Authorization
The next questions are in regards to customer information authorization. After your GTC Broadband Account is established, we still contact you to create account credentials.
Authorized Persons
The following people are authorized for GTC Broadband to discuss information and/or make changes to the account.
Authorized Person One
Authorized Person Two
Verification
Please enter your initials below to verify that the information on the application is correct. Your initials are also acceptance of financial responsibility for the account created from the application.
Please initial to accept the above statement: *
Application Received
Will be reviewed and processed within 3 to 7 days. All applications are processed based on when they were received. When the application is finalized by our customer service representatives, the location is approved, and all fees are paid, a service activation appointment will be scheduled.
Please initial to accept the above statement: *
If, construction is required to place a new drop, repair a damaged drop, or other unforeseen incidents occur, an additional waiting period may be required.
Please initial to accept the above statement: *
Proof of Identity will be required to proceed with application process. Once the application is completed and activation fees are paid, the standard wait time to activate service may be 7 to 10 days. Every effort is made to activate your service as quickly as possible.
Please verify that you are human*
Should be Empty:

Account Information

Activation Charge & First Month Service Fee

Choose Your Services

Support And Maintenance Plans

Acceptable Use Policy

Customer Information Authorization

Authorized Persons

Verification

Application Received