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Enhanced DSL Upgrade/Downgrade Form

Application Date

Account Information

Account Owner’s First Name

Account Owner’s Last Name

Email Address

Confirm Email

Account/Main Phone Number

Mobile Contact

Home Phone

Alternate Phone

Documents

ID Type - Select -Driver’s LicensePassportNational IDOther

Account Owner's ID

One file only.
2 MB limit.
Allowed types: gif, jpg, jpeg, png, pdf, doc, docx.

Are you the - Select -Legal RenterPower of AttorneyOfficial Authorised Person

Attach Copy of ID Card for Authorized Representative

One file only.
2 MB limit.
Allowed types: gif, jpg, jpeg, png, pdf, doc, docx.

Attach Copy of Power of Attorney

One file only.
2 MB limit.
Allowed types: gif, jpg, jpeg, png, pdf, doc, docx.

Speed

Current DSL Speed

Bronze (1.5 Mbps) $6,599

Silver (5 Mbps) $9,199

Gold (10 Mbps) $10,299

Future DSL Speed

Platinum (20 Mbps) $11,799

Gold (10 Mbps) $10,299

Silver (5 Mbps) $9,199

Effective Date

Sales Code

Sales Channel

Sales Agent Name

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