Business RTMC Application

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

Street Address

Street Address 2

CityState

Zip Code
Mailing Address

Street Address

Street Address 2

CityState

Zip Code
Do you want a phone line?*

YesNo
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 (.06¢/Minute Long Distance plan)$49.95 (Unlimited Long Distance plan)
Choose Your PHONE/INTERNET Bundle: (Includes Unlimited Calling) Taxes and fees not included.
Choose Your Internet Only Plan: (Wire Maintenance is required $2.95)*

300Mbps/300Mbps - $77.95600Mbps/600Mbps - $97.951GIG/1GIG - $137.95
Equipment (Required)*
Do you want voicemail*

YesNo
How many rings before voicemail answers?*
Installation Fee's*
Do you want email address from RC?*

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?*
Electronic Signature

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

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

Clear
Date*

MonthDayYear
Date
Should be Empty:

Business Application