Mohawk Networks Residential Activation Form How did you hear about us? Please choose one: How did you hear about us? *Chamber of CommerceColleagueDoor HangerFamilyFriendFlyerGoogle AdInternet SearchLive Event: Business Leader's BreakfastLive Event: Cheese FestLive Event: County FairLive Event: Meet & GreetLive Event: Town MeetingNewspaperPostcardRadioSocial Media: FacebookSocial Media: Google+Social Media: InstagramSocial Media: LinkedInSocial Media: TwitterSocial Media: YouTubeTelevisionYard Sign Service Location Information Do you rent or own this property? If you rent, we will send you a form to be completed and signed by your landlord before installation can be scheduled RentOwn Choose Your Services Internet service only. Please choose speed package No Internet25 Mbps - $59.9950 Mbps - $69.9975 Mbps - $79.99100 Mbps - $109.99 Do you need a router from us? Additional $9.99 per month YesNo, I have a router Would you like our Phone Services? $29.99 per month * one time activation fee of $13 per line YesNo Do you want your phone number to be UNLISTED? Additional $7 per month YESNO Would you like 80-Channel Video Service $64.99 Additional $6.99 per month for more than 2 TV's YesNo Acceptance of Terms & Conditions "I give Mohawk Networks permission to call/email me and perform an on-site survey if needed." Your Electronic Signature ** Your electronic signature is recognized as legally valid and binding, just as your signature is on paper, as per the Electronic Signatures in Global and International Commerce act (ESGICA) of 2000. ** Today's Date Submit