Panora Business Wireless Application NEW SITE

Wireless Internet Business Services

* designates required fields
Business Name*
Business Email Address*
example@example.com
Contact's Phone Number*
Contact's Email Address*
example@example.com
Additional Contact
Additional Contact's Phone
Physical Address*
City*
State*
Zip Code*
Billing Address*
City*
State*
Zip Code*
Paperless Billing

Visit panorafiber.com to sign up for eBilling.
I do not wish to receive a paper bill. understand that I can print off my bill if I choose from my online ebilling account.
Automatic Bank Payment
What type of account?

CheckingSavings
Name of Bank/Credit Union
Account Number
Routing Number
Bank/Credit Union Address
City, State, Zip Code
Bank Phone
Signature

Clear
Customer Proprietary Network Information (CPNI)
We will confirm the identity of callers by asking them to provide the answer to an authentication question listed below. Certain call information will not be shared over the telephone regardless of authentication. Instead, you can: 1) have the information mailed to you; 2) have us call you back at the number on your account; or 3) pick up the information at our office. Authorized contacts can discuss account information and make changes to your account. Authorized contacts will not be responsible for payment of your account.
What is your favorite color?*
I do want to add authorized contacts, They are listed here
Check if you DO NOT wish to add authorized users
By ordering and accepting Service, you agree to adhere to our Terms and Conditions and Internet Acceptable Use Policy, including any modifications as we may communicate to you from time to time. You can find the Terms and Conditions on our website. We will also send you a copy of our Terms and Conditions if you send your written request to our business address as shown on your monthly bill. Prices in this application do not include taxes or USF charges.
Applicant Signature*

Clear
Date*

MonthDayYear
A La Carte Services

All fees shown are charged on a monthly basis, unless otherwise noted
Fixed Wireless Internet

18/3Mbps - $74.9525/5Mbps - $84.9535/10Mbps - $99.95
Service level is dependent on geographical location. A no-cost site survey is conducted prior to service installation to determine accessibility and service level.
Managed Wi-Fi - See agreement

Managed WiFi - $10.95Extra Extenders - $4.95
Static IP
(qty) - $12.00 each
24/7 Tech Support Username & Email Address
INS Support Username
15 characters max
2nd Email Address
example@example.com
3rd Email Address
example@example.com
4th Email Address
example@example.com
5th Email Address
example@example.com
Installation Options

Standard - $129.95Advanced - $249.95
Installation Terms: Standard installation includes installation of wireless equipment and connection to 1 PC or router. Installations that require extraordinary time or resources will be billed an advanced installation charge in lieu of the standard installation. In the event of added installation charges, customers will be informed of the costs upfront. Customers requiring connection of more than one PC will be charged $60/hour plus hardware costs. Monthly service fee includes use of Panora Fiber equipment. Panora Fiber retains ownership. While the equipment is in the customers' possession, customer will be responsible for insuring the equipment against all physical damage for no less than its value ($695.00), naming Panora Fiber as sole loss payee.
Should be Empty:

Wireless Internet Business Services

Paperless Billing

Automatic Bank Payment

Customer Proprietary Network Information (CPNI)

A La Carte Services

24/7 Tech Support Username & Email Address