Satellite Signup Form

Enter your information below and one of our Sales Specialists will contact you within the next business day to confirm your Satellite order.

STEP 1: Select your Satellite Service Plan

Choose upfront payment or promotional pay option
SATELLITE PLANS	Small Office	Business Internet
Download/Upload Speed (max)	1.5Mbps/300Kbps	2Mbps/500Kbps
Satellite Equipment	HN7000S Modem .98 Dish Antenna 2 Watt Radio	HN7000S Modem .98 Dish Antenna 2 Watt Radio
Monthly Fee	$99.99	$179.99
UPFRONT PURCHASE Equipment and Standard Installation

UPGRADES - Select add-ons and/or system upgrades

No Upgrade:   Express Repair-Home - $5.95/mo:
Express Repair-Business - $12.95/mo:   Static IP - $20/mo (5 IP's):

STEP 2: Enter Account Information

First Name:
Last Name:
Email Address:
Primary Phone Number:	() -
Alternate Phone Number:	() -
Install Address (street):
City, State, Zip Code: , --Select state-- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming ,
Check this box to use same install address as Billing/Mailing address.
Billing/Mailing Address (street):
City, State, Zip Code: , --Select state-- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming ,

STEP 3: Request Your Installation - (Install date should be at least 5-7 days from sale date)

Preferred Day 5-7 days from sale date 8:00 AM - 12:00 PM 1:00 PM - 5:00 PM	Second Choice 5-7 days from sale date 8:00 AM - 12:00 PM 1:00 PM - 5:00 PM	Third Choice 5-7 days from sale date 8:00 AM - 12:00 PM 1:00 PM - 5:00 PM
* Requested install dates are not guaranteed *
Once you submit this form, we will be contacting you to confirm your order and verify your payment method. Only credit or debit cards will be accepted. WE DO NOT NEED PAYMENT UNTIL YOUR SYSTEM IS INSTALLED AND ACTIVATED. For immediate service, please call 1.888.628.4669.

Contact a Business Sales Consultant Today!
1.888.628.4669

VIP Support - 888.628.4669