Baldwin LightStream Sign-Up Form

Service Sign-Up/Upgrade Form

Complete the following form to the best of your abilities. Our team will be in contact with you soon.
Applicant Information
Name*

First NameLast Name
Are you a new or existing customer?*

New CustomerExisting Customer
Date of Birth*

MonthDayYear
Date
Phone Number*
Please enter a valid phone number.
Email
example@example.com
Best Day to Contact You?

MondayTuesdayWednesdayThursdayFriday
Service Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you own or rent?*

OwnRent
Landlord's Name and Number
Landlord permission is required for rentals.
Co-Applicant Information
Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Phone Number
Please enter a valid phone number.
Email
example@example.com

User Information
Desired User Name
If your desired user name is already taken, you will be notified to make adjustments.
Promo Code
Enter promo code if you have one.
Choose one of the following security questions to answer for your CPNI password.*
Hover to see CPNI information.
Type your security question answer here.*
A customer sales and service representative from Baldwin LightStream will contact you within 1-2 business days regarding your order. An install will be scheduled at that time.*
Were you working with a Baldwin LightStream employee prior to completing this form? If so, please enter their name.
How did you hear about Baldwin LightStream?

TVRadioNewspaperNeighborOnline SearchEmailOther
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Service Sign-Up/Upgrade Form