Please fax to 877-441-2368
Internet 2000 Wireless Commitment Form
Customer name
Address
City/ZIP
Phone number
Circle appropriate : Plan, Monthly Service and Install amount
Residential Plan			Business Plan
Monthly service	384K/384K*	$39.95	384K/384K*	$60.00
	512K/384K*	$50.00	512K/384K*	$70.00
	1.0M/384K*	$60.00	1.0M/384K*	$90.00
Administrative
	12 month commitment-			Admin setup =$99
Setup fee	Month to month commitment-			Admin setup =$299
Installation	Estimated installation due to your location			Up to            $______
In the event of early termination, customers choosing a 12 month commitment will be charged the month to month administrative setup fee.
The above installation cost is based on similar installations in your area which includes an antenna, radio, cable and computer setup.  Does not include network interface card, multiple computer networking, firewall or other equipment installation. If the quoted installation will not provide sufficient radio signal strength, a new quote for the additional cost of the installation will be provided at no charge.
The wireless radio and antenna equipment provided for service usage shall remain the property of Internet 2000. Upon termination of service, the customer is responsible for return of equipment to Internet 2000 or will be charged $485 for radio and $65 for antenna.
The above party, wishes to subscribe to the Internet 2000 wireless Internet service if the service is available at this location.  Payment for administrative setup and first month of service due on completion of Installation. If Internet 2000 is unable to meet the above terms then the above party is released from any obligation to accept service or installation.
* The above listed speeds are maximum available speeds and are not guaranteed.
Customer Signature				Date:
		(Office Use)
Equipment number			Signal