DSL is distance sensitive. You would not be able to get the service and bandwidth if you are too far away from the Central office. Please provide the following information so that we can check it out for you.
              ** Please provide e-mail address so that we can response to you by e-mail.
First Name
Last Name
Organization
Home Phone
Work Phone Ext Number
FAX
E-mail
URL

Please select one:

For Business User
For Home User

Please give us the location where the DSL service would be installed. This information is most important. All fields must be completed.  

*Street Address
*City
*State/Province
*Zip/Postal Code
*Phone Numbe at installation location

I currently access the Internet via:


My internet usage consists of:

Email
Web Browsing
FTP/Video Streaming
Mail Server
Web Hosting

Please tell us approximately how many users will be accessing this DSL line:

   

 

Questions and Comments:

 


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Revised: March 06, 2002