Fusion Internet and Streaming TV

Fusion Internet and Streaming TV

Service Application
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Internet & Streaming TV Services are billed one month in advance.
Date*

MonthDayYear
Date
Full Name*

First NameMiddle NameLast Name
Gender

MaleFemale
Are you transferring service to a new address?*

YesNo
Old Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Service Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing Address (if different)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Drivers License/State ID #
State
Email Address*
example@example.com
Cell Phone Number*
Please enter a valid phone number.
Work Phone Number
Please enter a valid phone number.
Home Phone Number
Please enter a valid phone number.

Payment Options
GEUS offers multiple payment options.

Choose to pay your bill using the GEUS App, Online Bill Pay, Pay-By-Phone, or Pay in Person options.

Visit our website to learn more about these easy to use payment options.

GEUS Payment Options

Agreement
The Applicant, whose signature appears below, applies to GEUS for some or all of the following services: Electric, Water, Sewer, Garbage, Streaming TV, Internet and other services incident thereto, to be supplied at the address herein described, and upon request, at any other local address to which Applicant may move. The Applicant agrees to pay for said services as bills are rendered therefore, in accordance with the rates, rules and regulations as provided in the City Charter or by City Ordinances as now existing or as may be enacted and in effect at the time of delivery, regardless of who the consumer might be. The Applicant further agrees to release and discharge said GEUS or the City of Greenville from a liability for damages suffered (1) by reason of electric or water currently furnished to the premises, or (2) by reason of interruption, discontinuance or disconnection of service hereunder from any cause other than negligence by GEUS or the City of Greenville or (3) by reason of the condition, maintenance, location, or existence of any of the facilities, fixtures or systems located on or adjoining the property supplied and by which services are furnished and delivered. Service requests for disconnections will be processed within 2 business days.

Applicant agrees to follow all current or as amended policies and procedures established in the Greenville City Ordinances and GEUS Service Policy. Such policies and procedures can be found on the links provided.

Greenville City Ordinances

GEUS Service Policy (PDF)

My signature is an acknowledgement that this is a contract and that I personally agree to make payments and am guaranteeing payment of all sums due and owing on behalf of myself and anyone using services at this address. Additionally, by submitting this form via electronically, I agree to conduct business electronically and an electronic signature is binding on me. If I move from this address, it is my responsibility to contact GEUS to terminate this account. I will remain responsible for the amounts owed on or services charged to this account until such time as I terminate this account.
I agree to these terms and conditions.
Applicant Signature*

First NameLast Name
Date

MonthDayYear
Date
Applicant eSignature

Clear
Should be Empty:

Fusion Internet and Streaming TV

Payment Options

GEUS offers multiple payment options.

Agreement