Broadband Value Plan APplication

DOB
Federal Employer Identification Number
Service Address
Mailing Address

Local Telephone + Long Distance + Broadband
(estimated plan prices, taxes & fees may vary)

All plans below come with Free Extended Community Calling if with Sirentel
*Installation Fee $99.00
Wireless Router Option
*Router purchased from Sirentel has 1 year limited warranty.
(Must be 8 letters, no more than 12)
(or we will default to My Network)
(To secure your router settings)
Switch Long Distance to Sirentel
*Customer Must Contact Long Distance Provider to Cancel Service
Included with Each Plan

I, the undersigned, am requesting a Siren Telephone’s Internet Account. By signing the agreement, I agree to the terms and conditions detailed in the policies found on Siren Telephone’s website, http://www.sirentel.com There is a monthly modem maintenance fee of $4.75, which covers the repair and/or replacement of the modem. Upon termination of Broadband service, the modem must be returned to the Siren Telephone’s business office or a $172.95 charge will be assessed. A $99.00 charge for early termination plus number of months left of 6-month connection will be accessed. Fiber modem stays at residence. Broadband customer will be assessed a monthly charge on their statement. Broadband service is billed one month in advance. Install fees & 1st month of service is required before installation of service. All above monthly prices are estimated (All prices subject to change). Broadband speeds may vary by location.
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