ILEC Sign Up Phase 4, 5 GTel ILEC Fiber Sign Up Phase 4, 5 First Name * Last Name * Date of Birth * Primary Phone * Secondary Phone Email (All correspondence including your service agreement, installation scheduler, and billing information will be sent to this email address.) * Service Address City State Zip Code Fiberhood How did you hear about GTel Fiber? * Email Community Event Direct Mail/Post Card Facebook GTel Employee GTel Service Truck Referred by a friend/neighbor Web Advertisement Web Search Yard Sign GTel Employee name * Friend/neighbor * Do you rent or own the property where you are looking for service? * Rent Own Landlord's name * Landlord's phone number * Is your billing address different from your service address? * Yes No 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 Code * Are you currently a GTel customer? * Yes No Click on the service titles below to select your levels of service Internet Service Current customers are required to select one of these new internet service offerings Speed Selection * PackageSpeedInstallation PricePre-Registration PriceMonthly Price GTel Ultimate 100 100 Mbps / 50 Mbps$49.00$79.99$99.99 GTel Everyday 50 50 Mbps / 20 Mbps$49.00$69.99$79.99 GTel Basic 25 25 Mbps / 5 Mbps$49.00$59.99 Select Your Router Option * Customer owned modem/router Standard Wired GTel Modem/Router (no monthly charge) Wireless Modem/Router ($3.95/month) Add Total Wifi to your service and take control of your in-home Wi-Fi network * Yes, I would like to add Total Wifi (up to two access points) for an additional $8.95/mo. Yes, I would like to add Whole-Home Total Wi-Fi (up to 4 access points) for an additional $15.95/mo. No Thank You Learn more about Total Wi-Fi Here TV Service Are you interested in adding any of these features to your current account? Cable Service * Local Basic Over 70 Channels! $29.99/mo GTel Basic Over 150 Channels! $96.99/mo Expanded Basic Over 200 Channels! Basic $113.00/mo I'm OKAY with my current service offering. Select a package to see details on included channels and services. Set Top Boxes (Installation = $75 first set, $50 each additional) Add value to your viewing without all of the fluff. Over 40 additional networks to explore! Channels include… All Basic TV channels plus popular networks like FXX, Destination America, Discovery Family, Science, Boomerang, RFD TV, Teen Nick, and seven Starz-Encore movie channels. Includes - Watch TV Everywhere and Primetime, All the Time! A great all-around video package. Channels include… All Local Basic channels plus news networks, sports (ESPN, Golf, YES, SNY, NHL, NFL, Big Ten), and popular networks like TBS, National Geographic, Discovery, Animal Planet, Disney, A&E, FX and Outdoor Channel. Includes - Watch TV Everywhere and Primetime, All the Time! Perfect for light TV watchers or homes with online streaming subscriptions. Channels include… ABC, NBC, FOX, CBS, The Weather Channel, QVC, C-Span and more! Plus, 50 digital music channels! Learn more about our Television offerings Here *A $75 installation fee applies to any new TV Service for the first set. Additional sets $50 at initial installation date. **Additional boxes are available for $5/box per month Number of Additional Wired Set Top Boxes? ($5/month) $50 install per set Number of Additional Wireless Set Top Boxes? ($8/month) $50 install per set, restrictions may apply based on home layout, location requests and distance from other devices HD Video Service Add HD Video ($10/month) Cloud DVR * 50GB DVR ($8.95/mo.) 250GB includes Whole Home DVR ($10.95/mo.) 500GB includes Whole Home DVR ($15.95/mo.) I do not want DVR service at this time Call ID on TV (must subscribe to phone service) Yes No Premium TV Services Starz ($9.95) Showtime & TMC ($17.95) NFL RedZone (per season) ($49.95) HBO ($18.95) Cinemax ($13.95) Click HERE to learn more about GTel TV and our Free Watch TV Everywhere service. Phone Service Add Telephone Service * Add home phone service ($23.00/mo. + $23.25 One-time install for first line) I’m happy with my current service Telephone Service * Add home phone service ($23.00/mo. + $23.25 One-time install for first line) Based on your location, you are required to have an active telephone service to maintain your Internet services with GTel Number of Phone Lines ($23.00/mo. + $23.25 One-time install for each additional line) * 1 Line 2 Lines Would you like to keep your current home phone number? * Yes No Who is your current home phone provider? * Current Phone Number * Current Phone Number Line 2 Long Distance Service * Value Plan ($0.13/min) 150 Minute Savings Plan ($14.95/mo.) 300 Minute Savings Plan ($19.95/mo.) 600 Minute Savings Plan ($34.95/mo.) Other Learn more about our calling features here Additional Calling Features Learn more about our calling features here (no label) Basic Feature Pack ($16.95/mo. [includes voicemail, call waiting, and caller id + 12 more features]) Wire Maintenance ($3.00/mo) Non-Published Phone Number ($1.35/mo) Call Waiting ($2.10/mo) Voicemail ($4.85/mo) Caller ID ($4.85/mo) Call Forwarding ($2.10/mo) No thank you. Battery Backup * Yes, I want a battery backup for only $2.00/mo (GTel will monitor battery and replace when needed) No, I prefer NOT to use a battery backup and I understand the risk. Note: Phone service will NOT work in case of power outage without a UPS battery backup installed. UPS will allow you to keep your phone line in service during a power outage for up to 8 hours (depending on usage). This is not mandatory, but without it, access to E911 will not work when power is out. More information can be found HERE Bill Payment and Additional Options Bill Pay Options * E-Bill (Get paid to go paperless! Receive a $2/mo credit when you choose paperless billing.) Paper bill (You can save $2/mo by selecting the E-bill option instead.) GTel Fiber Installation fee of $49 covers the first 500 feet of cable required to connect your home to the GTel network, please specify the distance you are from the main road next to your property in feet/miles. Additional installation charges apply over the allotted 500 feet. Please write in anything that our construction crews need to be aware of in your yard. (Dog Fence, Sprinkler System, etc) Any comments or additional information that we should be aware of? What is the best way to contact you? * Phone Email Mail While we work to coordinate the next step in the process, we’d like to know if you have any preferences on days or times that would best fit your needs when we work to schedule our upcoming installation dates. Please select all that apply Monday Monday Monday Time? * Morning (8:30 AM-12 PM) Afternoon (12:30 PM-4:30 PM) Both Tuesday Tuesday Tuesday Time? * Morning (8:30 AM-12 PM) Afternoon (12:30 PM-4:30 PM) Both Wednesday Wednesday Wednesday Time? * Morning (8:30 AM-12 PM) Afternoon (12:30 PM-4:30 PM) Both Thursday Thursday Thursday Time? * Morning (8:30 AM-12 PM) Afternoon (12:30 PM-4:30 PM) Both Friday Friday Friday Time? * Morning (8:30 AM-12 PM) Afternoon (12:30 PM-4:30 PM) Both Would you be interested in showing your GTel Fiber Pride by allowing our technicians to place a yard sign in your lawn for up to 2 weeks? Yes (you will receive a $5 credit when the sign is returned to our office. You can return the sign or one of our technicians will schedule to pick it up when he/she is in your area) No, thank you. Do you want to be a champion for GTel Fiber? * Yes No We will invite you to special events and may email you information to pass out to your neighbors I accept the services selected above and the charges associated to the selected services * Yes I agree No I do not agree If you do not accept the charges associated with the selected services, please do not submit this form. If you have questions regarding these statements, please contact our office immediately AT 518-537-4835 to avoid losing any of the above data. Please read the following terms and conditions before submitting this form Once this form is completed and submitted to GTel, I agree to activate service from GTel upon service being available at my location. I am either the owner of the potential service location or have permission from the owner to apply for GTel service. I agree to pay a $49.00 connection fee (additional installation charges may apply. If I choose not to take service after my location has been prepped for install, I will be responsible for any charges related to completed prep work. (*Monthly rates are subject to change, unless identified as a pre-registration rate within a specified time period. Voice service may be required, based on your location, to activate GTel Internet service.) I also give permission to be contacted by GTel regarding potential future GTel services. I give permission for GTel to make such contact via telephone, cellular phone, email, and/or postal mail regarding GTel services. If I choose to change these preferences, I can do so online or in the office by completing the proper authorization documents. Do you accept the above Terms and Conditions? * Yes I agree No, I do not agree If you do not accept the Terms and Agreements, please do not submit this form. If you have questions regarding these statements, please contact our office immediately AT 518-537-4835 or 844-537-4835 to avoid losing any of the above data. reCAPTCHA Submit If you are human, leave this field blank.