Add Services to Your Account Submit the form below to add an additional service to your account. Add Service Service OptionsService OptionsChoose which services you want to apply for. Check all that apply. *If you live in a coop area phone service may be required Bundled Services Bundled Package OptionsE-Vision Bundles only available to existing E-Vision customers. View more about the Streaming Bundle. View BundleStreaming Bundle - $99.95/moE-Vision 2 - $128.95/moE-Vision 3 - $146.95/moE-Vision 4 - $191.95/moService Digital TV Digital TV Digital TV OptionsChoose the Digital TV Package you want. View PackagesLifeline - $27.95/moBasic - $82.95/moEnhanced - $99.95/moService Internet Internet Internet OptionsChoose the Internet package you want. View PackagesUp to 50mbps - $84.95/moUp to 20mbps - $74.95/moUp to 15mbps - $59.95/moUp to 10mbps - $49.95/moUp to 6mbps - $34.95/moService Phone Phone Long Distance Plans*Choose an additional Long Distance plan?No, thanks$0.12 per min5,000 min/mo - $29.95/moAdditional Service OptionsChoose any additional options.Options if TV selected PVR - $6.99/mo Whole Home PVR - $3/mo Add HD HD Channel Package - $14.95/mo Options if Internet Selected Wifi Service - $5.99/mo Upgrade Internet SpeedUp to 10mbps - Add $24.95/moUp to 20mbps - Add $29.95/moUp to 45mbps - Add $34.95/moStreaming Bundle OptionsChoose any addons.Options if Streaming Bundle selected Local HD Channels - $5.99/mo DVR - $6.99/mo Wi-Fi - $5.99 Whole Home Wi-Fi - $12.95 Add STB - $4.95 40 Mbps for DSL customers - $14.95 100 Mbps for Fiber customers - $45.95 Service SupportTexPerts Service OptionsAdd a subscription to our TexPert Support. View PackagesNo, thanksAce - $15/moEpic - $17/moPrime - $20/moBasic InformationApplicant Name* First Last Email* Contact Phone Number*Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code I am aware there may be a deposit required for new service.* Yes Terms and Conditions24 MONTH COMMITMENT AGREEMENT This agreement (“Agreement”) sets forth the terms and conditions of the Etex Telecommunication services. The Residential Customer Agreement (“RCA”), incorporated herein by reference, contains additional terms and conditions. The RCA is available online at www.etex.net. Term Commitment: You must accept or decline the term commitment by initialing the appropriate space; if you do not initial either space, you will be deemed to have declined the term commitment. Accept Term Commitment Decline Term Commitment Details regarding you agreement depending on whether you accept or decline the term commitment. Length of Commitment: 24 months No Term New Subscriber Installation fee: $0 $75.00 Non-refundable PVR box lease fee: $0 $99.00/box Special Promotions and/or Discounts Eligible Not Eligible LEASE RESTRICTIONS: LIMITED TO A TOTAL OF 6 SET TOP BOXES for the installation discount in any combination. Additional set top box fees will be charged as set out and defined below under “FEES AND PAYMNETS”. Bandwidth limitations apply as defined below. Cancellation fee: If prior to the end of your term commitment, your service is disconnected for any reason or you downgrade your programming below a “Required Minimum Programming Package” (as defined below), and all programming and other charges for your term commitment have not yet been paid in full, you agree to pay, and we will automatically charge a cancellation fee to your account or your Qualifying Card (as defined below), at our option. $200 None Unreturned Equipment Charges: The Set Top Boxes and accessories, provided to you under this agreement are leased and remain the property of Etex Telephone Coop., Inc. at all times. You agree that you will return all such equipment in accordance with the “Equipment Return” section below within 30 days following downgrade or disconnection of service, and if you do not Etex Telephone will charge the following “Unreturned Equipment Charges” to your Qualifying Card. $100 Standard-definition (SD) non-PVR STB (Amino 125, ADB 2500, ADB2721W and Entone Hydra per standard-definition stream) or (the equipment as may be installed at the time), $150 high-definition (HD) non-PVR SSTB (ADB 3800, ADB 2721W, Entone Hydra or Entone Amulet), $300 Standard-definitions (SD) and high-definition (HD) PVR STB (ADB 5810, ADB 2721WX, Entone Amulet and Entone Hydra or such equipment as my be installed at the time). If your account is involuntarily deactivated for failure to pay your bill or otherwise, Etex Telephone will charge the applicable Unreturned Equipment Charge on your qualifying card within 30 days following deactivation if all equipment is not returned. Customer initial___ ***WE RESERVE THE RIGHT TO CHANGE PRICES, PACKAGES AND PROGRAMMING AT ANY TIME, WITHOUT LIMITATION, DURING ANY TERM AGREEMENT PERIOD WHICH YOU HAVE AGREED. ***WE RESERVE THE RIGHT TO CHANGE YOUR PAYMENT TERMS IF YOU FAIL TO MAKE PAYMENTS BY YOUR PAYMENT DUE DATE. ***YOU ARE STILL BOUND BY THIS AGREEMENT IF YOU CHANGE YOUR RESIDENCE. ***DO NOT SIGN THE AGREEMENT IF YOU DID NOT RECEIVE ALL 3 PAGES OF THIS AGREEMENT*** BY SIGNING THIS AGREEMENT, YOU ACKNOWLEDGE AND AGREE THAT YOU HAVE RECEIVED, READ, UNDERSTAND AND AGREE TO BE BOUND BY ALL THE TERMS AND CONDITIONS SET FORTH IN THIS AGREEMENT, INCLUDING WITHOUT LIMITATION, THE TERMS AND COONDITIONS SET FORTH ABOVE IN THE RCA, AND ALL SUCH TERMS WERE DISCLOSED TO YOU PRIOR TO LEASE. GRACE PERIOD: Customer has three (3) business days to revoke acceptance of this contract. In the event Customer desires to revoke acceptance, customer must notify ETEX with a request to revoke this agreement. Customer acknowledges that NO work will be preformed until after the three day grace period. Customer may waive the GRACE PERIOD, and ask for work to be scheduled sooner based on schedule availability. In the event customer waives the grace period, customer is bound by all terms of this agreement, and shall be liable for all obligations hereunder. In no event shall Customer be released once work has been initiated on the service. 24 MONTH COMMITMENT AGREEMENT Subscriber Eligibility: This offer is limited to: (1) new, first time residential subscribers: and (2) existing Etex subscribers who timely pays all balances due and owing on their other Etex account(s) in full; and (3) provides Etex with a social security number or other valid identification and a valid major credit card or debit/check card number, each issued to the customer who signs this Agreement; and (4) receives credit approval. Required Minimum Programming Packages: You must subscribe at all times to one of the “Required Minimum Programming Packages” listed below or a higher programming package. **Basic Digital, Enhanced Digital, Triple Play package 2, Triple Play Package 3, Triple Play Package 4, or PVR service (if applicable) Based on the limitation of bandwidth signal to you establishment. Additional equipment may be required and additional fees may apply in certain installations or with certain programming purchases. Set top boxes: The A125, ADB 2500, ADB 3800, ADB 2721W support 1 TV and contain 1 tuner. The Entone Hydra supports 3 TV’s, HD and PVR. The ADB 5810 and ADB 2721 WX support 1 TV but supports dual stream recording. Etex reserves the right to substitute and or replace equipment at its option. Fees and Payments: You agree to pay monthly by the payment due date for the programming you select and for all applicable fees. State and local taxes and /or reimbursement charges may apply as set forth in the RCA. You have paid or agree to pay the following on-time lease fees, if applicable: (A) $99.00 for each additional PVR set top box not discounted under this agreement. Other fees may apply as set forth in the RCA. The following monthly fees apply: PVR service fee $6.99/mo. (per PVR service) or $19.95 for 1 PVR service and access to HD channels to all STB’s. Every STB after the third is an additional $4.95/mo. Equipment Return: You may use the equipment provided under this agreement only while you remain an active customer in good standing and in compliance with this Agreement. You must return all such equipment in good operating condition, normal wear and tear accepted, within 30 days following downgrade or disconnection to any of the Etex business offices. You are responsible for and shall bear all costs and expenses of returning such equipment. Customer agrees that the equipment shall remain on the premises and that the equipment will not be moved to another location or used on another providers or customers service. You agree that Etex Telephone Coop., Inc. retains a lien against any Etex property in your possession and is entitled to immediate possession of any equipment hereunder, or installed if other equipment is substituted. In the event of a breach of any term of this contract, and said lien shall remain in full force and effect until such time as all equipment is returned to Etex Telephone Coop., Inc. at the termination of this contract. 24 MONTH COMMITMENT AGREEMENT Contract Information: If you have any billing, service or other questions, you may contact Etex at 903-797-4357 (HELP), or on the web at www.etex.net. By signing above, you authorize Etex to charge, and/or place hold with respect to all cancellation fee(s) and unreturned equipment charge(s), or any portion thereof, that you owe under this Agreement (collectively, the “Authorized Amounts”) to the credit card or debit/check card that you initially provided Etex (the “Qualifying Card”) until such Authorized amounts are paid in full. You may agree that the issuer of the Qualifying Card may accept this Agreement as your authorization and may pay the authorized amounts without Etex submitting a signed receipt. You agree to provide a current, valid credit card or debit/check card and to keep a current card available to Etex to guarantee payment. You agree to notify Etex should the card become invalid for any reason. You agree to notify Etex of any change in account status of any account used to guarantee payment hereunder, and to substitute such guarantees of payment as should become necessary. Etex reserves the right to demand substitution of another Qualifying Card or other guarantee of payment should the original Qualifying Card become inactive, cancelled or expired. Payment of cancellation fee(s) and/or unreturned equipment charges shall not relieve you of your obligation to pay all unpaid charges on your account. Customer agrees that this service agreement is subject to acceptance by ETEX, and that ETEX may decline to offer service in the event that it would not be feasible to offer service. Customer agrees and understand that this is a binding contract and that a breach of this contract is enforceable in any court of competent jurisdiction in Upshur County Texas and that, in the event of a breach, the prevailing party may collect attorneys fees in addition to its actual damages. Etex acknowledges that this agreement is not valid until accepted below by Etex. Digital Signature*By checking this box, you agree to all terms & conditions. Click here to read our Digital Signature Terms & Conditions. Yes NameThis field is for validation purposes and should be left unchanged.