Santa Rosa Wireless Sign Up

First Name *

Last Name *

Date of Birth *

Street Address

City

State

Zip

Your Fiberhood

Do you rent or own the property? *

Rent

Own

Property Owner Name *

Property Owner Contact Number *

Is your billing address different than your service address? *

Yes

No

Billing Address

Billing City

Billing State

Billing Zip

Email ( All correspondence including your service agreement, installation scheduler, and billing information will be sent to this email address. ) *

If you do not have an email, please use [email protected]

Contact Number

Preferred Contact Method *

Phone

Email

Are you an existing Santa Rosa customer? *

Yes

No

Internet Service

Available Internet Packages

Package	Speed	Price
Wireless 6.0	6 Mbps	$99.00
Wireless 3.0	3 Mbps	$79.95
Wireless 1.5	1.5 Mbps	$44.95

Router Options *

Enhanced Managed WiFi ($10.00 a month charge)

I want to use my own router (no additional charge)

Are you interested in Tech Home? Additional information can be found here

Tech Home Protect (1 computer) for $4.95/month

Tech Home Plus (4 computers) for $10.95/month

Tech Home Support (4 computers + 24/7 tech support) for $15.95/month

No, thank you

Tech Home is a complete home technology solution that makes it easy to setup, use, protect, and enjoy your networked devices…anytime, anywhere.

Bill Pay Options & Additional Information

Bill Pay Options *

Email Bill (Auto-Pay/Mail in Payment)

Paperbill and mail in Payment (An additional $2 fee will be charger per month)

Please write in anything that our construction crews need to be aware of in your yard. (Dog Fence, Sprinkler System, etc)

Questions/Comments

Terms and Conditions *

I agree to the Terms and Conditions

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Santa Rosa SignUp Wireless

Internet Service

Bill Pay Options & Additional Information

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