Akwesasne Internet Sign Up Account Name * Street Address * Billing Address (optional) City/Town State Zip Code Contact Phone Number * Alternate Phone Number Please select an internet speed plan * — Select from list — Fiber 100 ($75) Fiber 300 ($85) Fiber 500 ($105) Would you like our video services? — Select from list — PureHD TV ($70) DirecTV-Entertainment ($84.99) DirecTV-Choice ($99.99) DirecTV-Ultimate ($129.99) DirecTV-Premier ($174.99) Would you like our phone services? — Select from list — No thanks Yes add phone service ($29.99) Yes add unlisted phone service (additional $7 per month) Do you rent or own the property? — Select from list — Own Rent Please select a router — Select from list — Blast Max Router ($14.99) Blast Mini Router ($11.99) No thanks Would you like Wi-Fi mesh unit(s)? — Select from list — 1 ($4.99) 2 ($9.98) None Contact’s First Name * Contact’s Last Name * Contact E-Mail Address