Wireless Service Application
Name:
Address:
(No P.O. Box Please)
City:
Zip:
Email:
Confirm Email:
Phone:
Would you rather be contacted by phone or email?  
Phone    Email
Do you have cable TV?  
Yes    No
If yes, what cable company?
Do you have a satellite dish?  
Yes    No
If yes, what company?
Dish Network   
Direct TV   
Other    
Can you see the towers on Peaks Knob (Draper Mountain, all year)?
Yes    No
Draper Mountain is the mountain you see on the right as you go from Dublin to Pulaski beside I-81 with all of the large radio towers on it. At night 2 or 3 red beacons can be seen.
How many computers do you have?  
Do you own a Firewall?  
Yes    No
Do you own your home?  
Yes    No
Are you allowed to install a small antenna on the outside of your home?  
Yes    No
How did you learn about us?
Other information you might want to tell us:

Your Privacy is our utmost concern.  This information will not be released to any third party and will only be used for the purpose to contact you for this application.