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Mohawk Networks Fiber-to-the-Home Activation Form

Business Services
Please complete this form to sign up for Business Class Fiber-to-the-Home Services with Mohawk Networks.
How did you hear about us?
Service Location Information (where you want to have Internet service)
Phone Number Type:
Type of Building:
If you chose "Other", please describe your place of business below:
Do you rent or own this property?
** IMPORTANT: If you rent your home, we will send you a form to be completed and signed by your landlord BEFORE we can schedule your installation. **
Billing Information (where you want your bill to be mailed)
If you choose to become a customer, will your Billing Address the same as your Service Address you typed above?
If you selected NO, please give your billing address below:
Internet Service 
Which speed would you like?
Do you want a Dedicated IP Address?
Do you need a router device?
Voice Services 
Do you want a Standard Business Phone Line (with unlimited long distance, full-featured, with voicemail)?
If you chose YES to have a Standard Business Phone Line, do you want us to port your old number over or do you want a new phone number?
Do you want your phone number to be unlisted?
If porting your number over, please type your phone number (including area code) and current provider in the space below:
Are you interested in advanced voice features, such as SIP/VSX trunking, auto attendant, Fax to Email, Hosted PBX, and more?
Video Services
Do you want our 80-Channel Video Service (with a variety of premium channels included)?
If you would like additional televisions to be included with your service, please indicate the number in the box below. Additional televisions are $9.99 per month per television.
Other Fees You Need to Know About
  • Disconnection Fee (for Non-Payment): $25.00 per occurrence
  • On-Site Service Call Fee: $39.99 per service call (Does not apply if there are issues with our equipment or service and are applied at the discretion of the technician.)
  • There are additional fees for underground work or installation of new fiber, which may result in additional fees. An estimate of fees necessary for your location will be provided on a case-by-case basis as determined by the site survey.

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
*** To sign up for OPTIONAL Auto Pay Services, you will need to request an additional form
by calling or emailing our office. See your confirmation email for details. ***
Call Mohawk Networks