Adams Fiberhood Sign-Up and Interest First Name * Last Name * Address * City * State * Zip * Your Fiberhood Do you rent or own the property? * Own Rent Property Owner Name Property Owner Contact Number Is your billing address different than your service address? Yes No Billing Street Address Billing City Billing State AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Billing Zip Email Address * ( All correspondence including your service agreement, installation scheduler, and billing information will be sent to this email address. ) Contact Number * Date of Birth * Current Adams customer? * Yes No Internet Service* Please select your Service Package * PackageSpeedSign Up Now InstallationSign Up Now PricingStandard InstallationStandard Pricing Ultimate Gigabit 1000 MbpsFree!$74.95/mo$100.00$99.95/mo Elite 200 MbpsFree!$59.95/mo$100.00$69.95/mo Standard 50 MbpsFree!$49.95/mo$100.00$59.95/mo Please select your Service Package * PackageSpeedPre-Registration PricingStandard InstallationStandard Pricing Ultimate Gigabit 1000 Mbps$74.95/mo$50.00$99.95/mo Elite 200 Mbps$59.95/mo$50.00$69.95/mo Standard 50 Mbps$49.95/mo$50.00$59.95/mo FollowMyNetwork App Take control of your home network to view connected devices on your network, set basic parental controls, set up a guest network, or adjust your SSID and password. Smart Phone is required to utilize application. Free Version ProtectIQ: Network Security – $4.00/month ExperienceIQ: Enhanced Parental Controls – $4.00/month ProtectIQ: Network Security/ExperienceIQ: Enhanced Parental Controls – $8.00/month Not Interested Equipment Fees (required) * Required Equipment Fees ($6.50/mo.) Phone Service Local Phone Service Local Phone $15.00/mo per line No Thank You Includes Unlimited Local Calling, Voicemail & Calling Features, Plus keep your same phone number. Would you like to keep your current phone number? * Yes No Number of Phone Lines * 1 2 Who Is Your Current Phone Provider * Adams AT&T Comcast Frontier Windstream Cass Com Current Phone Number * Current Phone Number Line 2 Long Distance Options * 150 minutes for $5.95/mo. 300 minutes for $9.95/mo. 700 minutes for $19.95/mo. No thanks, I don’t need any long distance Would you like voicemail included with your phone line? Please note that voicemail is not needed if you currently use an answering machine. * Yes, I would like voicemail included No thanks, I will keep my answering machine Would you like your number to be listed in our online directory? * Yes, I would like my number listed in the Quincy Area Wide Directory No, I would like to be Non-listed No, I would like to be Non-Published ($1/mo) Your name, address, and phone number are not published in the Quincy Area Wide Directory, but your telephone number is available from Directory Assistance. Your name, address, and telephone number are not published in the Quincy Area Wide Directory and is not available from Directory Assistance.” How would you like your name listed? * UPS Battery – Note: Phone service will NOT work in case of power outage without a UPS battery backup installed. This is not mandatory, but without it, access to E911 will not work when power is out. * 8 hour UPS for $2.50/mo 24 hour UPS for $15.00/mo Not at this time Bill Pay Options & Additional Information Bill Pay Options * Email Bill (Auto-Pay / Mail in Payment) Paperbill (addl $2/mo charge) and Mail in Payment Account PIN * No more than 10 characters. Would you like to add an authorized person(s) to my account? * Yes, I would like to add an authorized person(s) to my account. No, Thank You Authorized Person #1 * Authorized Person #2 How did you hear about Adams Fiber? * Google/Search Engine Social Media (Facebook, LinkedIn, Twitter, etc.) News (Website, TV, Radio) In-Person Event Friend Adams Employee Please let us know which Sales Rep you talked to, Thanks. Nick Hoffman Brad Dooley Brenda Sprague Mike Ridder Ryan Buehler Jeremy Heaton Jess Van Beck Adams Fiber Yard Signs are a great way to increase interest in your area. Would you like to have a sign placed in your yard? * Yes, Please put a sign in my yard No, Thanks Please write in anything that our construction crews need to be aware of in your yard. (Dog Fence, Sprinkler System, etc) Questions or Comments Preferred contact method * Email Phone Terms and Conditions * I agree to Terms and Conditions If you are human, leave this field blank.