Full Name
*
Additional Responsible Parties
*
Billing Passcode (Mother's maiden name)
*
Cell Phone
*
Format: (000) 000-0000.
Home Phone
Format: (000) 000-0000.
Mobile Carrier
*
Permission to text
*
Yes
No
Email
*
Employer
*
How did you hear about service?
*
Did a friend refer to our service? Make sure to let us know so they can get a one-time bill credit! Then refer someone & get your own one-time bill credit
Service Address
*
City
*
State
*
Zip Code
*
Is your service address the same as your billing address?
Yes
No
Billing Address
*
City
*
State
*
Zip Code
*
Internet
Speeds
Standard - 100Mbps - $63/month
Premium -250 Mbps - $78/month
Turbo - 500 Mbps - $100/month
Rocket - 1 Gig- $152/month
No, I'm not interested in stand-alone internet services.
Telephone
Telephone
Telephone Line - $28.50/month
No, I'm not interested in telephone services.
Please verify that you are human
*
Submit
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