Step 1 of 6 16% Which services are you interested in? (Check all that apply)* Internet TV Phone Applicant InformationName* First Middle Last Utility Account #Service Address*Phone*Email* Will there be a spouse / co-applicant?*YesNoSpouse / Co-Applicant InformationName* First Middle Last Phone*Email* Existing Utility Service InfomationDo you own or rent?*OwnRentLandlord's Name*Landlord's Phone*Service Location*Inside City LimitsOutside City LimitsElectric Services*AerialUndergroundElectric Meter Location*On HomeOn PoleApprox. Pole Distance to Home* Internet ServiceSelect Speed*100 Mbps ($44.95)250 Mbps ($64.95)1 Gig ($104.95) TV ServiceSelect Channel Package*Basic ($19.95)Standard ($74.95)Enhanced ($89.95)Digital Tier Options Sports Tier (18 Channels–$5.95) Latino Tier (10 Channels–$5.95) Premium Channel Options*1 Premium Channel ($14.95)2 Premium Channels ($26.95)3 Premium Channels ($36.95)4 Premium Channels ($46.95)NoneSelect Premium Channels* Cinemax Starz & Starz Encore Showtime/TMC HBO How Many HD-DVRs would you like?*The first is FREE. Additional units are $9.95 each.How Many High Definition (HD) boxes would you like?*Units are $5.95 each. Phone ServiceNUconnect Phone for $32.95*I'd like to keep my existing home numberPlease assign a new numberIncludes Unlimited Local & Long Distance Calling (taxes and fees included)Please include the following features: Include All Voicemail Call Return Caller ID (Name & #) Call Forwarding Call Blocking Call Waiting Your existing phone number* CAPTCHA
