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Choctaw Communications Residential Internet Only Service Agreement

*First Name:

*Last Name:

*Email:

*Phone Number:

*Work Number:

*Mailing Address

Service Address - City, State, Zip

*If different than Mailing Address

Residential Choctaw Communications Broadband Only Access

Up to 15Mbps Down - $84.95per mo.

Up to 25Mbps Down - $94.95per mo.

Up to 40Mbps Down - $99.95per mo.

Up to 50Mbps Down - $104.95per mo.

Up to 75Mbps Down - $109.95per mo.

Up to 100Mbps Down - $114.95per mo.

*Please Acknowledge:

**ANY PROMOTIONAL PROGRAM IS OUTSIDE OF THESE PRICES AND SUBJECT TO TIME LIMITATIONS**

Residential High-Speed Internet Access Service Options and Charges - 24 Month Contract. Note: Actual speeds may vary. See Service Level Agreement form for actual factors that may cause speeds to vary.

Terms & Conditions

*Agree to Terms and Conditions

I wish to recieve a paper invoice monthy. I do understand that this will be an additional monthly fee of $2.50

I wish to recieve an electronic invoice monthly. A valid email address for me is listed below:

Email:

This field must be left blank

Residential Internet Only Sign Up

Thank you for choosing Choctaw Communications.

Choctaw Communications Residential Internet Only Service Agreement

Residential Choctaw Communications Broadband Only Access

Modem/Router

*Customer Owned Equipment Acknowledgement

Installation Services

Surge Protection

Firewall Protection

Virus Protection

Wireless Security

Promotion Agreement

"Optional"