Sign Up for Internet or Home Phone Service

Primary Account Holder Information

Name *

First

Last

Cell *

I authorize WST to contact me at this cell phone number. *

I understand

Email *

Service Address *

Address Line 1

Address Line 2

City

State

Zip Code

Mailing Address/PO Box *

Address Line 1

Address Line 2

City

State

Zip Code

Previous Address (if less than 6 months at current address)

Address Line 1

Address Line 2

City

State

Zip Code

Current Employer *

Driver's License Number *

Social Security Number *

Date of Birth *

When do you need service? *

Requests for Internet service include a soft credit inquiry to the credit reporting bureaus for all applicants. This does not affect your credit score. WST’s due diligence when connecting a person to the Internet includes taking measures to prevent unlawful access to the Internet network. As part of WST’s verification procedures, all applicants are required to provide their Social Security Number and government issued photo ID. WST is doing its part to protect you and your personally identifying information from fraudulent activity. Your data is stored in a secure data center with limited employee access. Data Center is a mission critical site secured by layered digital and physical cybersecurity measures and redundant power. Data Center is PCI compliant. PCI standards for compliance are developed and managed by the PCI Security Standards Council. *

I understand

Is there a Secondary Account Holder?

Yes
No

Which applicant should we designate as the billing contact? *

Primary Account Holder
Secondary Account Holder

Secondary Account Holder Information

Name (Secondary Account Holder) *

First

Last

Cell *

I authorize WST to contact me at this cell phone number. *

I understand

Email *

Service Address (Secondary Account Holder) *

Address Line 1

Address Line 2

City

State

Zip Code

Mailing Address/PO Box (Secondary Account Holder) *

Address Line 1

Address Line 2

City

State

Zip Code

Previous Address (Secondary Account Holder) *

Address Line 1

Address Line 2

City

State

Zip Code

Driver's License Number (Secondary Account Holder) *

Social Security Number (Secondary Account Holder) *

Date of Birth (Secondary Account Holder) *

Employer (Secondary Account Holder) *

Customer Privacy Policy

Privacy Policy and Identity Protection Procedures. We value you as a customer and we know how much your privacy means to you. In the normal course of providing you telecommunications service, Wheat State Technologies collects and maintains certain information about you, whether it is the information actually contained on your monthly phone bill or information specific to your identity. Wheat State Technologies uses this information to conduct our business, to advise you of our products and services, and to provide you with excellent customer service. When you contact one of our customer CARE centers for assistance we may verify your identity prior to accessing your account information. This is to protect your identity and prevent fraudulent activity from occurring. We may ask you to verify information that identifies you as the primary account holder. Any information that we collect from you will be used to identify you, your consumer identity and your account information– these safeguards have been implemented to protect you from fraud and/or identity theft. Wheat State Technologies Privacy Statement: Wheat State Technologies does not sell customer information. In order to protect customer information, we use technology and procedural safeguards to protect your privacy. We review our policies and practices, and monitor our customer CARE centers and computer networks to prevent unauthorized access or usage. We may be required to disclose your customer information for legal and regulatory reasons such as a court order, to investigate fraud or other unlawful uses of communications services. We may also share your customer information with consumer credit-reporting agencies to verify your identity and/or credit history, and provide information to collection agencies as necessary. We respect your privacy and we're committed to keeping you informed and protected.

Please confirm: *

I acknowledge that I have read and understood the company privacy policy.

Please create an Account User ID: *

Please use your favorite email address, or if you don't have one, WST can create one for you (_________@wheatstate.com).

Create Account Password: *

PROTECT YOURSELF AGAINST FRAUD
Weak passwords make you vulnerable to fraud Fortunately, it’s not hard to create strong passwords — it just takes a little extra effort. The goal is to make a password appear to be a random string of characters to hackers, but easy for you to remember. Here are a few tips to help you create a stronger password: STRENGTH TIPS for STRONG Passwords
❶ Make it Lengthy Use at Least 8 Characters
❷ Combine letters, numbers, & symbols. Use at least 1 of the following: number character, a upper case letter, & a special character.
❸ Use a sentence as the starting point. Think of a memorable sentence, take the first letter of each word, then mix up lower case and upper case, and replace some letters with numbers and symbols.
❹ Avoid sequences or repeated characters. "12345678" or "222222"
❺ Don’t use dictionary words. Criminals use tools that can rapidly guess passwords based on words in dictionaries, words spelled backwards, & misspellings.

Please select a security question. *

Answer to security question. *

Telephone Service Selection

Your Residential Phone Service Base Price is $18.75 to $30.55 / month. Phone Installation fee of $24 will be added to your first month's bill. Please choose additional plan options below.

Would you like a Listed Number or Unlisted Number *

Listed
Unlisted - $1.00 per month
I am not ordering phone service

Long Distance *

*Basic Plan not available in a bundle plan.

Advanced Calling Features

Fiber Broadband Internet Service Selection

Internet Only Service *

Fiber Broadband Internet Service for Landline Customers *

50/20 Mbps - $49.99/month
100/50 Mbps - $69.99/month
250/100 Mbps - $79.99/month
1 Gig/1 Gig - $119.99/month

Relax with Service Guard

You can guard against budget-busting repairs with Wheat State’s SERVICE GUARD.

SERVICE GUARD includes all the benefits you need to protect your Wheat State services – voice and Internet – diagnosis, repair, replacement parts for interior wiring, and if your router needs replaced, your high-speed Internet equipment will be replaced with the model currently being provided by Wheat State. And, we’ll show you how to get the most out of your equipment to make sure your Wheat State services are trouble-free.

Without SERVICE GUARD, you’ll pay a $25 trip fee, $75/hour for labor and up to $125 for equipment replacement!

Choose one: *

Service Guard - $6.95/month includes FREE professional Internet installation.
No Service Guard - I understand I will pay the $25 trip fee, $75/hour for labor and up to $125 for equipment replacement for any service call.

Free Special Offers

Choose your FREE install offer for your Internet Service: *

Sign me up for a FREE install with AutoPay.
Sign me up for a FREE install with Service Guard.
$99 Internet Installation; not interested in special offer.

AutoPay Service

It’s beyond easy. Your Wheat State bill is paid every month – on time – by automatic withdrawals from your bank or credit card account. Safe, secure…and convenient! Your phone bill is mailed or e-mailed to you each month. The amount due is deducted automatically from your bank account or charged to your credit card around the 10th of the month. The amount deducted is shown on your bank or credit card statement.

E-Statement Service

Save time and trees with online statements. Do something nice for yourself and Mother Earth. WST provides paperless billing. You may use your Account User Name and Password created above to access your account. Every month your statement will be e-mailed to the email address you specify. You may access your statement from your online account at https://wheatstate.com/my-ebill-account/.

Subscribe to AutoPay and your install is free. Eazy-Peazy!

Do you want to sign up for AutoPay? *

Yes
No

Enroll in AutoPay

Your bill is mailed or e-mailed to you each month. The amount due is deducted automatically from your bank account or charged to your credit card around the 10th of the month. The amount deducted is shown on your bank or credit card statement. Questions? Click here or call us at 1-800-442-6835.

Payment Information

Choose Payment Method: *

CREDIT CARD AUTOPAY
CHECKING ACCOUNT AUTOPAY

Select One:

Visa
Mastercard
Discover
American Express

Name as it appears on card: *

Card Number: *

Expiration (MM/YY): *

Card Verification Value (CVV): *

I hereby authorize WST, to initiate CHARGE transactions to my credit card account as indicated. *

I understand

Bank Name *

Bank Address *

Address Line 1

Address Line 2

City

State

Zip Code

Routing Number: *

Account Number: *

I hereby authorize WST, to initiate debit entries to my checking account indicated and the depository named above to debit same to such account. This authority is to remain in full force and effect until COMPANY and DEPOSITORY have received written notification from me of its termination in such time and manner as to afford COMPANY and DEPOSITORY a reasonable opportunity to act on my request. *

I understand

Internet Agreement and e-Signature

Broadband Internet Service Agreement

If signing up for internet services you must initial, sign, and date this form.

INTRODUCTION: It is agreed that agreements are made only on the terms and conditions herein. This document is an offer by you (Customer), which will become a contract only when accepted in writing by Wheat State Technologies (Company). This document contains the terms on which the Company will provide you, the Customer, with high speed Internet service (Service) using the Company’s Network (Network). By use of the Service you agree (for yourself and any other person you allow to use your Service or the Network) to be bound by these terms and conditions. The Company may change these terms and conditions by giving you at least ten (10) days notice at your billing address. You agree to be bound by those changes unless you cancel your Service in writing prior to the effective date of such changes. Cancellation is subject to term conditions.

SECURITY: The Company will not be responsible for any corrupted file or viruses that affect the user of the Service. It is your responsibility to safeguard your system, through appropriate means (e.g. using passwords or commercially available software) from theft, unauthorized use or system corruption. Any firewall-type software or hardware installed on your system will be your responsibility to configure and will not be supported by the Internet Tech Support staff. Due to the “always on” nature of the Service technology, any detriment caused to your computer system as a result of your failure to properly secure it will be your responsibility. Any detriment caused to the Network as a result of your failure to properly secure your system may result in the immediate suspension of your Service.

The Company sends out a monthly statement for service by the last working day of the month. All bills are due and payable by the 15th of the month. A late fee of 3% will be applied to any balance due that is not received in our office by the due date. Payment must be received by the due date to prevent service suspension. All overdue accounts without an authorized payment extension are subject to having all services disconnected. If your account is suspended for non-payment your service will be subject to a $24.00 reconnect fee Returned checks will be assessed a $30.00 service charge.

Broadband Internet Service Agreement (continued)

PERFORMANCE LEVELS: Data speeds quoted in Service are maximum speeds. Speed performance is subject to upstream Internet conditions and may be lower because of peak capacity, PC hardware and software, wiring conditions inside your premises and website congestion. Data speeds are delivered on a “best effort” basis and are not guaranteed. All plans are subject to network availability.

TERMINATION OF SERVICE: Service shall not be used for ANY PURPOSE THAT VIOLATES THE LAW or in any manner that will interfere with the use of Service by one or more Customers. Unlawful or interfering uses are grounds for termination of your Service. The high-speed Service provided is for the specific location designated and use at or by another location or involving the resale of bandwidth or any other part of the Service is prohibited. The Company may also terminate your Service for non-payment or for any violation of any of the terms contained herein. You may terminate your Service at any time after the initial commitment period by notifying the Company of your intention to do so. You are responsible for payment of outstanding charges for the period of time in which the Company provides you Service.

LIMITATIONS OF WARRANTIES: The Company will use good faith efforts to provide continuous satisfactory Service. However, Service may be temporarily interrupted because of weather conditions, governmental orders, system modifications or repairs, system capacity limitations, security measures, equipment malfunctions, etc.

If Service is interrupted for more than 48 hours other than by negligence or willful act of the customer, an allowance at the published rate for the Service at the time of interruption shall be made for the time such interruption continues, after notice and demand to the Company. No other liability shall in any case attach to the Company on account of interruptions of Service.

LIMITATION OF LIABILITY: In no event will the Company be liable, under any legal theory, for lost business, profits, or revenue, damage, accident, injury to person or property (including death) or any other losses, claims, or damages, including any incidental, special or consequential damages, caused, arising from or related to, directly or indirectly, your (or any other person’s) use of your internet Service, the Company’s equipment, the Company’s network or Service, or the Company’s provision or failure to provide or make available such network or Service.

Guidelines for Internet Use

All broadband subscribers must adhere to the Acceptable Use Policy of the High Speed Internet service. This policy was formulated: to protect our network, our users, and the Internet community as a whole from harmful, inappropriate, illegal or otherwise objectionable activities. To ensure the security, reliability, and privacy of our systems and network, as well as the networks and systems of others. To encourage the responsible use of Internet resources. To preserve the privacy and security of individual users. Prohibited Internet activities subject to termination of service include fraudulent conduct such as: Spamming or promoting illegal money-making schemes, disseminating illegal materials, infringement of intellectual property rights such as the illegal downloading of: MOVIES, MUSIC, and other copyrighted materials.

We want to ensure a safe, high-quality Internet experience for everyone, so please review your complete Internet Service agreement received during installation or call for a copy. If you are unsure whether any contemplated use or action is permitted, please contact us at 1(800) 442-6835 and we will assist you.

PLEASE SIGN BELOW: I have read the Broadband Internet agreement carefully, fully understand its contents, and voluntarily agree to its terms. *

Date *

Sign Up for Residential Internet or Phone Service

Primary Account Holder Information

Secondary Account Holder Information

Customer Privacy Policy

Telephone Service Selection

Your Residential Phone Service Base Price is $18.75 to $30.55 / month. Phone Installation fee of $24 will be added to your first month's bill. Please choose additional plan options below.

Fiber Broadband Internet Service Selection

Relax with Service Guard

You can guard against budget-busting repairs with Wheat State’s SERVICE GUARD.

Free Special Offers

AutoPay Service

E-Statement Service

Subscribe to AutoPay and your install is free. Eazy-Peazy!

Enroll in AutoPay

Payment Information

Internet Agreement and e-Signature

Broadband Internet Service Agreement

If signing up for internet services you must initial, sign, and date this form.

Broadband Internet Service Agreement (continued)