Name:
Phone:
Email:
Business Name:
Street Address:
City:
Zip:
Existing Internet Connection: DSL Cable Other
Internet Service Provider: or, provide me with a FREE ISP recommendation:
Anticipated use of wireless connection, please provide as much information as possible (ex. web surfing, network access, file sharing, VPN connectivity, etc.):
Need for additional services during wireless setup:
Anti-Virus Software:
Anti-Spyware:
Backup:
Parental Control Software:
Wireless Printing:
Other (please explain):
EXISTING WIRELESS:
Type of equipment (make, model, date purchased):
Desired services (ex. Install, review security, increase reliability, increase speed, etc.):
NEW WIRELESS:
Provide a FREE recommendation on what I should buy:
Provide a quote for OneHourWireless to supply required wireless equipment:
How did you hear about us?
Existing OneHourWireless customers:
