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Seasonal Rate Form

Complete the form below to place your Elevate internet service on a seasonal rate. Only the person(s) listed on the account can request this rate.

Important Reminders:

• The seasonal rate applies to your internet service only.

• You are required to stay on the seasonal rate of $20/month for internet service for a minimum of two months, but no longer than six months during one calendar year.

• Your internet service will be reduced to 1 Mbps for the duration of time your account is on the seasonal rate. You are responsible for contacting Elevate to reinstate your normal service level. No changes will be made to your phone or TV services

First name

Last name

Phone

Account number (if known)

Address line 1

Address line 2

City

State

Zip

Date you would like to implement your seasonal rate

Conditions of service

I understand that by submitting this form I am agreeing to a minimum of two months (but no more than six months within one calendar year) of internet service at the rate of $20 per month with the speed of 1 Mbps.