Atlanta GA DSL
Account Information
 
* First Name:
 
 
* Last Name:

 
 
Company:

 
 
* DSL Phone Number: ?
 
 
Alt. Contact Number:
 
 
Address:
 
 
Address2:
 
 
City:
 
 
State:
 
 
Zip:
 
Service Information
 
Please note that an active telephone line with dial tone from AT&T/Bellsouth
must be maintained in order for Atlantic Nexus to provide the service.
 
       
   
Residential
Business
 
 
*Service Type: ?
1.5Mb x 256Kb - $35/month
3.5Mb x 384Kb - $40/month
6.0Mb x 500Kb - $50/month
1.5Mb x 256Kb - $60/month
3.5Mb x 384Kb - $80/month
6.0Mb x 500Kb - $90/month
 
 

Concierge Service
This monitored and managed service handles router and wireless problems for you.
Concierge service Includes wireless router no charge, free remote support & static ip address
more info

 
 
Hardware
 
 
No Hassle setup: All of our hardware comes pre-configured with your
personal settings so you don't have to spend time trying to figure it out!
 
       
       
 
Static IP: ?
 
 
Installation: ?
 
 
Need an  Email Address: ?
      @atnex.net
 
 
Requested Email Password:?
 
Billing Information
 
Credit Card:
CC Number:
Exp Month:
Exp Year:
CC CVV: ?
 
Name on Card:
 
  If you would like to receive a copy of your order, please provide a current working email address.  
 
Current E-Mail Address:
 
 
Installation/Turn-up Date
 
 
If you have requested professional installation, we will contact you to schedule an appointment.
Standard turn-up timeframe is usually between four and five business days.
 
 
Expedite My Order!
+$4.99 - Expedite my order for turn-up as soon as possible
 
Overnight Shipping
+$9.99 - Ship my modem for delivery the next business day
 
 
Referral Information
 
 
How did you hear about us?
 
  If Friend/Family, list their name and we will credit their account $10.00  
   

Questions/Comments:



I HAVE READ AND AGREE TO THE TERMS AND CONDITIONS OF SERVICE and understand I must pay for a minimum of six months of service regardless of use and I must maintain an active phone line with AT&T in order to maintain service with Atlantic Nexus.


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