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brightWireless Service - Sign-Up Form  

 
Customer Contact Information
Business:
Contact:
Address:
City: State Zip Phone
County:            
Social Security Number:
 
Technical Information:
Computer Operating System:
 
brightWireless Packages (Please choose a Package)

 
Additional Information:
Extra Features Desired:
 
Comments:
By clicking on the submit button, you agree to abide by SAA bright.net's Terms and Conditions of Service.  If you have any questions on brightWireless Service, please call 1-888-438-8436 prior to clicking the submit button.  On you click the button, a brightWireless representative will verify that service is available for you and will contact you.  Service will not be ordered by us until we have made contact with you.  If you cancel service prior to the end of your contract term, you will be responsible for a $200.00 early termination fee.  If your account becomes more than 90 days past due, a $65.00 reconnect fee will be applied to your account.

By clicking on the submit button, you are also agreeing to have a credit check run on your account.  If you do not our credit requirements a deposit may be required in order to get service installed.

 
 

This site is Copyright 2002 by SAA bright.net, Inc. * Travis B. Sheaffer, CCNA, RHCE Webmaster