Wireless Application Form

Contact Information:

Full Name
Service Address  
911 Address
2 Closest Crossing Steets (Town Addresses Only)
Email
Telephone
Alternate
Pricing:

Install Fee: $100 (house mount)
Install Fee: $150 (pole mount)

Residential - $40-45 (depending on location)
Business - $49-54 (depending on location)

Requirements:

Network Interface Card (inside customer computer)
64mb of ram
Windows 98 or higher
Credit / Bank Card on File
 

To add more computers customers will need a switch or router. Wilnet can supply a 4-port ethernet router with wireless (call for pricing). Any additional cabling or networking will be $45.00 per hour plus material.

What town are you located in:
*At the current time we only service the following 4 cities.*
Millcreek   Ada   Maysville   Wayne
Stringtown

Are you able to get:
Cable   DSL   Satellite   Other None

What type of house do you have:
Brick   Trailer   Siding   Other

**Do you have a Debit or Credit Card?**
Yes   No

Are you an existing WilNet Customer?
Yes   No

Is there any type of existing pole located on/beside your location:
Yes   No

How many computer do you want to connect to the service:

Do your computers' have a NIC (network interface card):
Yes   No   Unknown

Best time to contact for Installation:
8-10am   10am-12pm   1-3pm 3-5pm

Best day to contact for Installation:
Monday   Tuesday   Wednesday Thursday  Friday

Enter your comments in the space provided below:

Click Here to contact Support


WilNet Communications
Copyright © 2006 [WilNet Communications]. All rights reserved.
Revised: 02/20/06.