Perry: Interested or Ready to Sign up

First Name *

Last Name *

Address *

City *

State *

Zip *

Email *

Home Phone

Cell Phone *

Ready to Sign up? or just getting info at this time? *

I'm ready to Pre-Register & pay $50 to "Lock in my Price for Life", Save $60/yr off Standard Price & Free Install

I'm interested, but need more info (please continue to fill out form and we will contact you back)

Please select your Service Package *

Bill Pay Options *

Email Bill and Auto Pay via (Checking Acct)

Email Bill and Auto Pay via (Credit or Debit Card)

Email Bill and Mail in Payment

Paperbill (addl $2/mo charge) and Mail in Payment

Undecided

Managed Wireless Router Support & Maintenance for only $2.50/mo (Recommended)
For a description of what is included, click here *

Yes

No

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. *

Yes - I want a UPS for only $2.50/mo (Adams will monitor battery and replace when needed)

No - I elect NOT to use a UPS and I understand the risk

I would like more LD Minutes with my phone service *

No Thanks - 150 minutes is plenty

300 minutes for $4.00/mo more

700 minutes for $14.00/mo more

How did you hear about Adams Fiber? *

Preferred contact method *

Email

Phone

Questions or Comments

Pay Pre-Registration sign-up fee *

Via Paypal

By Contacting Adams at 877-696-4611

Terms and Conditions *

I agree to Terms and Conditions

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