I wish to take advantage of bright.net-BRT's Annual Payment Plan for bright.net Gold (unlimited number of connections) customers. By enrolling in the Annual Payment Plan, I will be receiving 12 months of service for the price of 11 months. That is a savings of over 8%!

I understand that I am under no obligation to participate in the Annual Payment program. I also understand that should I leave bright.net-BRT for any reason, that the first month's credit I am receiving will be forfeited. The balance, if any, on my account will be refunded to me. I understand that I will continue to be billed annually, unless I contact bright.net-BRT to revert to monthly billing.

I called / stopped at the bright.net-BRT office

on ______ / ______ / ______ and

was given the amount of $__________ to make as my annual payment. That amount is enclosed with this form. Please enroll me in the bright.net-BRT Annual Payment Plan.

Signed________________________________________

User ID________________________________________

If you wish to enroll in the bright.net-BRT Annual Payment Plan, please print this form, fill it out completely, contact us for the amount of your annual payment, then send or drop off the payment and the completed form to our local office at 140 Main Street, Benton Ridge, OH 45816.

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