Broadband Qualification Form  
Call 352-684-1067 for any signup problem! You will be called back within 24 hours if an associate is unavailable

Fill out the form below. Field names marked in red are required to be filled out. This form will determine whether or not you qualify for our Broadband services.

Please Note: When performing a Broadband pre-qualification if the phone number and address is a business you must enter the name of the business in the provided "Company Name" space. supports nationwide DSL from the following; ATT, Bell South, SBC via ATT, Qwest, Verizon and Covad. With the exception of Covad you must have at least one local telephone from one of these providers to have DSL provisioned at your location. This is because the FCC ruled that your local phone company does not have to provide line sharing.

Please call (800)-791-2564 to sign up with