Please enable JavaScript in your browser to complete this form.Name *FirstLastWould you like to add another name to the account?FirstLastShould you desire to add an additional name to the account for our staff to work with incase of questions.Email *Phone *Address *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeMonthly Internet Service *1GB/1000MBPS - $89.00150MBPS - $59.00Internet services carry a 2 year contract to maintain service at your address. Full Feature Phone ServiceMonthly - $27.00Paper Bill Fee *DECLINE - $0.00Please mail my bill - $5.00Monthly bills are emailed. If you would like a paper copy there is a $5.00 monthly charge. Monthly Total$0.00Special Requests or InstructionsTerms and Conditions *I Agree to the termsThis contract is for the services listed above. You agree to keep service for the period stated above in the Term of Service section of the contract. If you fail to keep the service or fail to make timely payments, service may be disconnected and you will owe the remainder of the contract. You agree to pay the total amount upon receipt of invoice from ACME Communications, Inc. Monthly bills are emailed. If you would like a paper copy there is a $5.00 monthly charge. Acme may require a nonrefundable down payment of $125 to be made prior to installation. This payment will go toward your monthly services. The payment for your router (if applicable) must also be made prior to installation. Once you have read and signed this contract, the order for your service will be submitted. A technician will be dispatched to install your service. Any additional cable installation is billed to the customer at a rate of $45 / half hour. We are not responsible for equipment other than that provided by, or purchased from ACME Communications. This does not include equipment "given" as a promotional offer. All equipment provided by ACME Communications not purchased by the customer (i.e. ADB Set Top Box(es), Power Supplies, NID/Modem, Battery Back-Up, & Firewall/ Routers) must be returned upon termination of service or the customer will be charged replacement price for the unreturned equipment.Install and 2 year commitment *I acceptThe install price will depend on your home, and needs. Minimum instillation price is $150.00. You agree to keep service for 2 years.Underground facilities and private utilities are NOT Acme Communications liability *I understandAcme is not responsible for damaged private utilities and facilities that are not marked. Acme will call 811 for a utilities locate of your home. You must locate and mark any private utility buried in your yard prior to us digging. ie: Dog fence, Water lines, Electrical to sheds, sprinklers, septic, lamp poles, etc. If there is a possibility of a conflicting private utility please provide any information you have including your address, name and phone number to support@adsnet.com .Drivers License Number *Date *Captcha * = Submit
