Please complete the following form to request new services in the Watertown and Big Stone Lake areas. I am applying for:* Internet Telephone Applicant desires service as:* Residential Business Full Name* First Last Social Security Number*Spouse's Name First Last Spouse's Social Security NumberAddress*The physical address where services would be installed Street Address City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Mailing Address (if different from physical address) Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Contact Number*Please provide a telephone number we can reach you at regarding this request.Email*RC Technologies keeps your email address confidential. Enter Current Email Confirm Email Have you had telecommucation services before?* Yes No Previous telecommunications companyYour current employer*Work telephone numberPlease list names of all members of the household over 18 years oldName of party who lived at location last, if knownHow did you hear of RC's services?*NewspaperRadioFriends / FamilyName of friend / family member that referred you, if applicable. First Last I choose to:* Register for a tnics email address Utilize my current email address only I would like to add the following services to my internet account Secure IT Virus protection - $4.95 per month File Hopper - 5 GB Storage - $3.95 per month File Hopper - 50 GB Storage - $6.95 per month File Hopper - 250 GB Storage - $14.95 per month Password Genie - $1.75 per month I would like my wireless network (SSID) name to be:*SSID must be at least 6-8 characters (up to 17 characters) and cannot start with a number. I would like my wireless password to be:*Password must be at least 8 characters with at least one capital letter and one number. Applicant desires optional Wire Maintenance $2.00 per month*Protects against service call charges for inside wire and phone jacks. Covers all of your RC services. Yes No Do you want your name published in the telephone directory:* Yes No If no, do you want it unlisted or non-published Unlisted - $2.00 per month - Not listed in the directory, but is in directory assistance. Non-published - $3.00 per month - Not listed in the directory or directory assistance Which address(es) would you like listed in the directory Physical Mailing None Your name as you would like it to appear in telephone directory First Last Because of timeframes for updates to other area directories, it's possible your new telephone listing will not be included in their upcoming directory. However, your listing will be available from directory assistance and will be included in the RC directory. I acknowledge by signing my name below that I have read and understand the above advisory*If your account is listed only in your name, you may want to consider adding another name, if appropriate, e.g., a spouse or a roommate. If you are a parent or individual that relies on someone else to discuss account changes, payments, or anything else with our company, you will need to have that person’s name added to your account. The name does not need to be added to the billing name but can be added to our records as an authorized person for discussing information and making changes to your account.* No, I do not want to add any additional contacts to my account. Yes, I would like to add authorized contacts to my account. Please enter names of additional contacts you would like to authorize.The FCC has implemented rules to protect the privacy of information contained in your account. The rules allow us to discuss account information only with the person(s) listed on the account. Also, RC must be able to authenticate that person and will do that by asking a specific question to which you have previously provided the answer. RC has always treated your account information with confidentiality. In order to ensure your information is protected, please provide an answer to the question "In what city were you born?"* City State / Province / Region The undersigned (hereinafter called the applicant) hereby applies for service in the RC Technologies., New Effington, South Dakota (hereinafter called the company). applicant agrees upon the following terms and conditions: 1. The Applicant will be charged, as appropriate, non-refundable service order and installation fees at the company’s tariffed rates and price list. The applicant may also be required to make a deposit. 2. The applicant must be at least 18 years of age. 3. The applicant will receive service from the company at his/her place of residence and/or business, and will pay therefore monthly rates to be determined from time to time in accordance with the tariffs and policies of the company. The applicant will also pay to the company all just and proper charges accruing to long distance carriers who employ the services of the company for billing and collection purposes if applicable. 4. The applicant will grant to the company, as appropriate, a right-of-way easement to construct, reconstruct, operate and maintain telecommunications and information services, cable or system on or beneath the applicant’s land and in or upon all streets, roads or highways abutting said land. Such easement shall be granted for the purpose of serving the applicant or other customers of the company when such easement is necessary to provide service in the most safe, efficient and economical way possible. If the facilities are constructed underground, the company may record such. 5. The applicant agrees to comply with the payment terms and policies as may from time to time be determined and adopted by the company. Upon acceptance of Applicant’s application, and receipt of services from Company, Applicant shall become a patron of Company subject to the terms and provisions of RC Technologies Restated Articles of Incorporation and Bylaws, which shall constitute a contract between the Company and Applicant. A copy of Article 8, Cooperative Operation, of RC Technologies Bylaws is available upon request.*Please InitialI hereby apply for Voice / Data services from RC Technologies, with the understanding that I am fully responsible for payment of the account. Your electronic signature will enter you into a binding contract with RC Technologies. Internet installation is free with a 24 month agreement. Early cancellation fees of $20.00 per month remaining in agreement will apply. Please type your full name*Please attach a copy of Photo ID.*Accepted file types: jpg, pdf.Applications cannot be processed without a copy of your photo ID. PhoneThis field is for validation purposes and should be left unchanged.