Northwest Communications - Web Design and Hosting, eCommerce, Shopping Cart
    

 

 

DSL Internet Application

*Denotes Required Fields

INTERNET PLANS
   
  * You must choose from one of the below plans.
   
  All Residential Plans include: Equipment, 5 emails, virus filtering, spam filtering on primary email, Family Web Filter.
   
  Residential 10Mb/1Mb* - $39.95/Month - Plus $75 Installation
  Residential 9Mb/3Mb* - $59.95/Month - Plus $75 Installation
  Residential 12Mb/3Mb* - $79.95/Month - Plus $75 Installation
  Residential 15Mb/5Mb* - $139.95/Month - Plus $75 Installation
   
  All Business Plans include: Equipment, 10 emails, virus filtering, spam filtering on primary email, and Family Web Filter. Website hosting also available for an additional charge.
   
  Business 10Mb/1.5 Mb - $49.95/Month - Plus $75 Installation - Price good with Telephone Service, Price varies otherwise.
  Business 12Mb/3 Mb - $79.95/Month - Plus $75 Installation - Price good with Telephone Service, Price varies otherwise.
  Business 15Mb/5 Mb - $139.95/Month - Plus $75 Installation - Price good with Telephone Service, Price varies otherwise.
  Business 15Mb/10 Mb - $249.95/Month - Plus $75 Installation - Price good with Telephone Service, Price varies otherwise.
  Business 15Mb/15 Mb - $299.95/Month - Plus $75 Installation - Price good with Telephone Service, Price varies otherwise.
     
     
 

*Speeds dependent on network activity.

Customers with critical requirements, such as hospitals, governmental agencies and large organizations - call for pricing. Direct circuits available in most areas.

Standard Installation includes installation of wireless equipment and connection to one computer. 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 $75 per hour plus additional materials. Monthly service charge includes use of Northwest's antenna and transceiver equipment. Ownership is retained by Northwest Communications.

     
 

SecureIT Application

Addittional Comments:

   
CUSTOMER INFORMATION
  *Are you currently a Northwest Internet Customer?
Yes No
     
 
*Email address of person
completing this form:
     
  Service Address
 
*First Name:
 
*Last Name:
 
*Street Address:
 
*City:
 
*State:
 
*Zip:
     
  Billing Address
 
Billing Name (if different):
 
Mailing Address:
 
City:
 
State:
 
Zip:
     
 
*Home Phone with Area Code:
 
Work Phone with Area Code:
 
Cell Phone with Area Code:
 
County:
     
 
*Location of service:
 
If Rent, Landlord's Name:
 
Landlord's Phone Number
     
 
How did you hear about this service?
     
     
E-MAIL ADDRESSES
   
  EMAIL GUIDELINES
Email address must be sixteen characters or less with no punctuation. Email password must be at least 6 characters with some being alphabetical, numerical, and upper case. If address and/or password is unacceptable or unavailable, one will be chosen for you.
   
  Primary E-Mail Address
 
1st Requested Choice
 (Or current NCN e-mail address):
@ncn.net
 
Requested Password

8 characters minimum, at least one uppercase, one lowercase, and one number.
 
Would you like spam filtering activated on this e-mail account?
Yes    No
 
I already have an email account
and will not need one with this service:
 
Email address you can be reached at if not using a ncn.net email address:
     
 
*Would you like our Family Web Filter?
Yes    No
  Click here for more information regarding these options!
     
 

Virus e-mail filtering included with every account. Spam e-mail filtering and Family Web Filter are included free with accounts.

Cost of these services when not included in plans: Spam Filtering - $3.00 per month;
Family Web Filter - $5.00 per month; Spam & Family Web Filter Package - $6.00 per month

Filtering Activation fee is waived if connected at time of Internet installation; $10 fee for Spam Filtering, $25 fee for Family Web Filter if activated later.

     
  Additional E-Mail Addresses
  Residential accounts receive 2-10 emails and business accounts receive 5-10 email addresses depending on speed. You may request additionals for $3/month for residential and $5/month for business accounts.
     
 
2nd Additional E-Mail Address:
@ncn.net
    Include spam Filtering
 
Requested E-Mail Password

8 characters minimum, at least one uppercase, one lowercase, and one number.
     
     
 
3rd Additional E-Mail Address:
@ncn.net
    Include spam Filtering
 
Requested E-Mail Password

8 characters minimum, at least one uppercase, one lowercase, and one number.
     
     
 
4th Additional E-Mail Address:
@ncn.net
    Include spam Filtering
 
Requested E-Mail Password

8 characters minimum, at least one uppercase, one lowercase, and one number.
     
     
 
5th Additional E-Mail Address:
@ncn.net
    Include spam Filtering
 
Requested E-Mail Password

8 characters minimum, at least one uppercase, one lowercase, and one number.
     
     
COMPUTER SYSTEM
     
 
Minimum
Recommended
Memory: 512 MB of RAM
PC OS: Windows XP
MAC OS: OSX

Memory: 1 GB or More
PC OS: Windows Vista or 7
Mac OS: OSX 10.6

*Must have Ethernet card.
  We do not support any PC operating system older than Windows XP
     
SALES INFORMATION
     
 
Sales Agent or Buddy:
 

Buddy credits will not be paid on applications taken to Authorized Northwest Sales Agents.

Your buddy will receive a $50 Visa Gift Card for referring you to Northwest Communications. Some restrictions may apply.
*Buddy credit ($50 VISA Gift Card) will not be given until the Internet service has been installed and has had service for 3 months.
     
     
PAYMENT INFORMATION
     
  *Please bill me monthly via:
Mail      Credit card      Debit my checking account automatically      E-Bill (CSR will contact you regarding setup)

For automatic bank deduct and credit card payments, click here to download the form to mail.
Credit Card | Bank Deduct
Please complete the form and mail it to our office at 844 Wood St., Havelock, IA 50546.
     
     
CUSTOMER SERVICE AGREEMENT
     
  I 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 Servicesmay change fromtime to time upon 30 days notice. The Service is provided on an "AS IS" and "ASAVAILABLE" BASISWITHOUTWARRANTIESOFANY 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.
     
  I accept and understand the Customer Service Agreement and the Standard Installation Terms.
  If you do not agree, click this button to exit without submitting this application: 
     
  Please enter the following security code in the next field. For ease of use, only the characters 1 - 9 and A - F are printed. You may enter upper or lower case characters.
 
     
   
     

 


 
   
 
i wireless
800-249-5251 | Email | Northwest Telephone
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