- Residential Services
Applications & Forms.
All of our fillable applications in one spot for your convenience.
Residential Service.
GRTI Residential Application for Service
Online Form
GRTI Residential Application for Service
PDF Version
Service Line Agreement Form
Authorization For Records
Right-Of-Entry Permission Form
Lifeline Program.
Form 5629: Lifeline Program Application Form
Pages 1–8
Form 5630: Lifeline Program Annual Recertification Form
Pages 1–7
Form 5631: Lifeline Program Household Worksheet Form
Pages 1–4
Elder Concession.
Elder Concession Application
Employment
GRTI Application for Employment
How to Submit
To Download a Form
PC or Mac: Right-click the download button and select “Save link as” to save the form to your computer.
To Submit via Email
1. Download the PDF and use the fillable form feature to complete it. Save your changes via File → Save As.
2. Open a new email in your preferred email platform.
3. Address the email to grti.info@gilarivertel.com
4. In the subject line, specify the form name (e.g., “DSL APPLICATION”).
5. Attach the completed document using the paperclip icon and click Send. A Customer Service Representative will contact you within 24 hours.
Need Help?
Our Customer Service Team is happy to assist you with any forms or applications. Give us a call or send us an email.