La Grange Springs Sign Up

First Name (Legal) *

Last Name *

Service Address *

City *

State (2 character abbreviation) *

Zip Code *

Email *

(All correspondence including your service agreement, installation scheduler, and billing information will be sent to this email address.)

Phone Number *

Is your billing address different from your service address? *

Yes

Billing Street Address *

Billing City *

Billing State *

Billing Zip Code *

Internet Monthly Charges

*Note - We offer 2 installation options below. A self-install for $0 and an option for a Colorado Valley Technician to install for $80.

Are you interested in landline telephone service? *

No Thank You

Yes, please have a customer service rep contact me about landline telephone service

Installation *

Self Install - No Charge

$80 Colorado Valley Technician On-Site Installation

Comments/Questions

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