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Advanced Net DSL Pre-Qual
 

 

Advanced Net DSL
Pre-Qual

The following form below will help you Pre-Qual for Advanced Net DSL Internet Access. If you have any questions please contact us at our office.

     


STEP ONE: ACCOUNT INFORMATION

Name:
 		  Company:
Address:
City:
 State:
 Zip Code:
Contact Number:

Please enter number with dashes 
(e.g. 810-984-3488)

Number to install DSL on:

Please enter number with dashes
(e.g. 810-984-3488)
E-Mail Address:


STEP TWO: COMPUTER AND TELEPHONE INFO

Computer Type
Operating System:
Number of PC's:
Do you already have a network card:

 


STEP THREE: REVIEW AND SUBMIT