Customer Contact Information
Your Name*
Co-Applicant Name
Current Mailing Address*
City*
State*
Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Zip Code*
Phone Number*
Email Address*
How did you learn about us?*
Neighbor Internet Search Facebook Radio Ad Newspaper Ad Door Hanger Yard Sign Other
Billing Preference*
I would like to receive my bill electronically and save $1.00 every month I would like to receive a paper bill in the mail
Enter Your Service Address
Service Street Address*
Service City*
Benson Cascabel Chino Valley Dewey Eloy Prescott Prescott Valley Saint David San Manuel Scottsdale Young Bayview Cascade Ketchum Lakeview McCall Midvale Secesh Stanley Warm Lake Warren Weiser Yellow Pine Annex Ontario
Service County*
Choose Your Services
After selecting your service area (above), choose a service package. Rates are per month and do not include tax.
Service Comments/ Additional Features
Directory Information
Choose One:
Listed With Address
Listed Without Address
Non-Listed*
Non-Published**
*Non-Listed: Listed in operator information file, but not in telephone directory. Available from information operator. Additional charge required.
**Non-Published: Not listed anywhere. Not available from information operator. Additional charge required.
List in Directory as:
Long Distance Service
Do you want long distance service?
Yes
No
If yes, it is the customer's responsibility to contact the long distance carrier of choice. The carrier will then notify MTE of the customer's choice and every effort will be made to ensure that service is connected to the long distance carrier chosen. In the event service is inadvertently connected to a different carrier, MTE will assume liability only to the extent of connecting service to the chosen carrier at the earliest opportunity after receiving notification of the error. Customer service representatives will be happy to answer any questions about this process.
MTE Billing Information
For telephone service connection, customers must pay an installation fee of $25 and provide one of the following:
Positive credit reference (copy of current or recently paid phone bill)
A $50 deposit
The installation fee and deposit, if required, must be paid prior to the connection of service.
Monthly local service charges will be billed during the next regular billing cycle. Depending upon the service connection date, the first statement could include prorated charges from the date of connection through the end of that month. In addition, because local service is billed in advance, the statement will also include the local service charges for the billing month. Customer service representatives will be happy to answer any questions regarding billing.
Reminder notices are sent to customers if payment has not been received by the 20th of the month. If payment has not been received by the end of the month, the customer will receive a disconnect notice. The date of service termination will be printed on the notice. If service is terminated, prior to restoration of service, the customer will be required to pay all past due and current charges, plus a reconnect fee.
MTE's responsibility is to provide dial tone to the Network Interface Device (NID) on the exterior of the business or dwelling. Connecting to the NID, interiorly, will be the responsibility of the customer, as will all wiring, telephones, computers, data, video, or other equipment.
MTE Statement of Non-Discrimination
The US Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, religion, age, disability, political beliefs, sexual orientation, and marital or family status. (Not all prohibited bases apply to all programs). Persons with disabilities who require alternative means for communication of the program information (i.e. Braille, large print, audiotape, etc.) should contact USDA's TARGET Center at 202-720-2600 (voice and TDD.)
To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, Room 326 W. Whitten Building, 14th and Independence Ave, SW, Washington DC 20250-9410 or call 202-720-5964 (voice and TDD.) USDA is an equal opportunity provider and employer.
Federal Data Collection Information
As a recipient of federal loans and funding, MTE is required to identify and document as accurately as possible, the racial/ethnic data on the eligible population in our service areas. Please assist us in this data collection by selecting the appropriate group below.
PLEASE NOTE: Your response is optional. The information you provide will be used only for Federal Government reporting purposes. Should you have any questions, please contact the business office of MTE at 208-355-2211 or 800 462-4523.
Decline to State
White (Not of Hispanic origin)
Black (Not of hispanic origin)
Hispanic
American Indian or Alaskan Native
Asian or Pacific Islander
Customer Proprietary Network Information (CPNI)
MTE collects information such as particular services used, numbers called, frequency and duration of calls and billing records regarding the use of the telecommunication services that customers purchase from us. The company collects this information (CPNI) in order to provide the services requested and bill appropriately for services rendered.
MTE may use customer information without customer consent to market enhancements to services already used. For example, the customer purchases basic local phone service. The company does not need the customer's consent to use customer information to attempt to sell voicemail or caller ID service. However, MTE must have on file, the customer's completed "Opt-out" or "Opt-in" consent form before sharing customer information within the company in order to sell services the customer does not already have; for example, attempting to sell long distance service to a customer who has only subscribed to local service. If MTE uses customer information for other marketing strategies, consent must be given.
The customer has a right to the confidentiality of his or her information and MTE has a duty under federal law to protect that confidentiality. The customer has a right to consent (Opt-out) , or to oppose (Opt-in) , the proposed access, use, disclosure and/or distribution of customer information. Because of these rights and new FCC rulings, MTE requests that customers make a choice as to the release of information affecting the type of marketing information they might receive.
Please select ONE of the following options:
Opt-out gives customer consent to share their information allowing MTE, as well as any additional company, to market to the customer any specific communication needs, innovative products, service offerings, package discounts, etc. that may better meet the customer's communications needs. The "Opt-out" choice will be valid for up to two years, but may be changed by notifying MTE in writing of the desire to do so.
Opt-in gives customer consent to MTE only , to use their information for marketing campaigns, special offers, new services, package discounts, etc. that may better meet the customer's communications needs. The "Opt-in" choice will remain in effect until changed by the customer, by means of written notification to MTE.
NOTE: Not selecting an option to authorize customer information for marketing purposes, automatically classifies the customer as an "Opt-out" customer , making the customer eligible to receive all marketing materials.
Customer Authentication Request
In order to prevent release of any customer information to an unauthorized person, new rulings from the FCC state that a customer must be "authenticated". Unless the customer provides a password, MTE will not release customer information over the telephone during a "customer initiated" call.
MTE requests that the customer choose a password, and provide answers to four simple questions (one of which will be asked if the password is forgotten.) Please do not use readily available biographical information, (i.e. mother's maiden name, SS number or last four digits, date of birth, or home address.)
Password*
Back-up Questions/Answers:
Your favorite color:
Your favorite soup:
Your favorite flower:
Your favorite month of the year:
Please list the names and relationships of other individuals who may receive your account information (i.e. children, caregiver, interpreter, significant other, and/or spouse.) If no one is listed, MTE will only disclose requested information to the customer of record whose name/names appear on the APPLICATION FOR SERVICE. Remember, anyone asking for your information must provide your password.
THEIR NAME
RELATIONSHIP
Sign and Submit
I agree that all of the information I have provided herein is true and accurate. I have read the paragraphs detailing billing procedures, warnings and the disconnect process for failure to make payments and agree to those terms.
I have read the Statement of Non-Discrimination and the Acceptable Use Policy .