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Order now form

Please complete our order form below to begin processing your request for fios internet.

Company Name:

 Billing Phone number:
Service Street Address:

City, State, ZIP:

Your Name:

Your Position:

Your Phone:

Your email:

QTY phone lines?

Confirm email:

Domain name:

Tax ID:

Domain Transfer:

Installation:

Email Choice:

Add'l QTY PC's:

Would you like to add phone service?

IP Addresses:

Operating System:

Internet FIOS Service Plan:

Billing Address:

 * Both static or dynamic IP and service options must match.

Ownership Type:

 One time set up fee: $ 88.00 / for 1 PC
Includes 20MB Personal web space * Add $75.00 for each additional PC
Includes Verizon Internet Security Additional Hardware
Includes 1 Yr of Domain registration Wireless router:
Includes 30 - Day Money Back Gaurantee Wireless USB Adapter:
     
       
       
       
       
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