Request for WiFi-4-You Wireless Internet Service
Please provide us with the following contact information. We will not share your information with anyone.
We will perform a pre-qualification for your location and notify you of the results.
Please allow 24 hours for us to process your request. We look forward to serving you.
*Required Field
Name
*
First
Last
Installation Address
*
Address
Address Line 2
(lot, suite, trailer, etc)
City
State
(AZ Only)
ZIP Code
Email
*
Phone
*
###
-
###
-
####
Best time to call
Will this be for your Home or Business?
*
Home (personal use)
Home Office (personal and work)
Business
Select the Speed Plan you want:
*
Basic - 800k/300k - $30/mo
Plus - 1400k/350k - $40/mo
Pro - 2000k/400k - $50/mo
Extreme - 3000k/450k - $65/mo
Ultimate - 5000k/500k - $75/mo
Business Service (any tier)
Requested Install Date:
1
2
3
4
5
6
7
8
9
10
11
12
MM
/
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
DD
/
2012
YYYY
Which install option will you be taking?
*
$130 up front (Residential Only)
$150 split into 3 payments of $50 (Res Only)
This is a commercial install ($200)
I'm not sure yet
How many devices will be sharing this connection?
*
Just 1
2 - 4
5 or more
Do you need a Static-Public IP Address?
*
No
Yes
Don't know
Please add any additional information or requests here (optional):
Powered by
EMF
Forms Online
Report Abuse
EMF Forms Online
EMF Forms Online