Have you ever been a Northwest Communications customer? * Yes No Service Address Name * Street Address * City * State * Zip * County * Billing Address Billing Name (if different) Mailing Address City State Zip Phone Phone with Area Code * RESIDENTIAL Internet PlansService includes: 5 emails, virus filtering, spam filtering on primary email, and virus protection. Residential Speeds Broadband: 6Mb/1Mb - $30/Month, Plus $35 Installation Broadband Plus: 10Mb/2Mb - $40/Month, Plus $35 Installation Broadband Premiere: 15Mb/3Mb - $50/Month, Plus $35 Installation BUSINESS Internet PlansService includes: 10 emails, virus filtering, spam filtering on primary email, and virus protection. Business Speeds Broadband: 6Mb/1Mb - $60/Month, Plus $35 Installation Broadband Plus: 10Mb/2Mb - $80/Month, Plus $35 Installation Broadband Premiere: 15Mb/3Mb - $100/Month, Plus $35 Installation Installation & Speed TermsCall for higher speeds. Availability will be determined by a site survey. Customers with critical requirements, such as hospitals, governmental agencies and large organizations, please call for pricing. Direct circuits are available in most areas. Standard Installation includes installation of wireless equipment and connection to one computer for $75.00. Customers may use their own wireless router. Please notify the representative if you have your own device. If you do not have your own device you will be charged $75.00 plus tax for the purchase of a wireless router through Northwest Communications. Installations that require extraordinary time or resources will be billed an additional charge. Customer will be informed of charges prior to installation. Customers requiring connection of two or more computers will be charged an hourly rate, plus additional materials. Monthly service charge includes use of Northwest's antenna and transceiver equipment. Ownership is retained by Northwest Communications. Do you own a wireless router? If you don’t own a wireless router and would like wireless access, Northwest Communications will provide equipment to you at no cost. The equipment will be owned and maintained by Northwest Communications. * Yes No Location of Service * Own Rent Landlord Name Landlord's Phone Number How did you hear about this service? * - Select -Friend/Relative (see Buddy Program below)FacebookWebsiteMarketingOther Buddy Other Buddy ProgramIf a current Northwest Communications internet customer has referred you to Northwest Communications, they will receive a $50 Visa gift card. The Buddy credit will be given once your Internet service has been installed and in service for 3 months. ENTER THE NAME OF YOUR BUDDY IN THE SPACE ABOVE. Some restrictions may apply. Cannot be combined with any other offer. Northwest Communications has the right to end this promotion at any point in time. Family Web FilterFamily Web Filter is included with your internet subscription. More information about this service. Would you like our Family Web Filter? * Yes No Current Email Address Email address of person completing the form * NCN.NET Email AddressEmail address must be sixteen characters or less with no punctuation. Email password must be at least 8 characters with some being alphabetical, numerical, and upper case. If address and/or password is unacceptable or unavailable, one will be chosen for you. 1st Requested Choice (or current NCN e-mail address) 2nd Requested Choice (if first isn't available) Requested Password Computer SystemMinimum Requirements: Memory: 512 MB of RAM; PC OS: Windows XP; MAC OS: OSX; Must have an ethernet card. Recommended: Memory: 1 GB or More; PC OS: Windows Vista or 7; MAC OS: OSX 10.6 We do not support any PC operating system older than Windows XP. Payment Information Please bill me monthly via * Mail E-Bill (CSR will contact you regarding setup) Customer Service AgreementI understand and acknowledge that continued use of Northwest's Services constitutes acceptance of the Terms of Service, Acceptable Use Policy and other important policies posted on Northwest's website www.ncn.net. I agree it is my responsibility to read these policies and comply fully with their terms. I further understand the policies and pricing of Northwest's Services may change from time to time upon 30 days notice. The Service is provided on an "AS IS" and "AS AVAILABLE" BASIS WITHOUT WARRANTIES OF ANY KIND, EITHER EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO WARRANTIES OF TITLE OR IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. If service is cancelled, customer agrees to return equipment in working order within 10 business days or pay an equipment charge of $100-$800. Accept Terms * I accept and understand the Customer Service Agreement and the Standard Installation Terms. CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Math question * 12 + 7 = Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.