Business RTTI Application

Business Application
Company Name*
Email*
example@example.com
Phone Number*
Tax ID #
Primary Contact*
Contact Name
Address*

Street Address

Street Address 2

CityState

Zip Code
County*
County
Mailing Address

Street Address

Street Address 2

CityState

Zip Code
Do you need a phone line?*

YesNo
Do you want to keep same phone number?*

YesNo
If yes, what is your existing phone number?
How many phone lines?
Do you want your phone number published/Non-published?*

PublishedNon-Published ($1.50/mo)
List in Directory as

Choose Your Business Phone Plan:*

$39.95 (6¢/Minute Long Distance Plan)$49.95 ( Unlimited Long Distance Plan)
Choose Your INTERNET ONLY Plan: (Wire Maintenance is required $2.95/mo)*

300Mbps/300Mbps - $77.95600Mbps/600Mbps - $97.951GIG/1GIG - $137.95
Choose Your PHONE/INTERNET Bundle: (Includes Unlimited Calling) Taxes and fees not included. Cat5 wiring required with Fiber installation.
Equipment (Required)*
Installation Fee's*
Do you want a email address from RTTI?*

YesNo
Create your own username for your email address
Create Email Pswrd
Minimum 8 characters, alpha/numeric/1capitalized letter)

Protect Your Account with these SECURITY QUESTIONS (Answer at least 2 questions)
Select Your question*
Model/make first car
1st elementary school you attended
Name of best friend in high school
Favorite animal
School's mascot
Favorite holiday
Select Your question*
Model/make first car
1st elementary school you attended
Name of best friend in high school
Favorite animal
School's mascot
Favorite holiday
Create Account Pin*
(Create your own account pin of 4-digits)
How did you hear about us?*
Terms & Conditions *Must scroll through terms to select the box.
Electronic Signature

by typing and signing your name, you agree this is an electronic signature.
Name*

First NameLast Name
Signature with mouse/finger/stylus:*

Clear
Date*

MonthDayYear
Date
Image Picker
Should be Empty:

Business Application