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Purchase WildBlue Satellite Internet Service

Central Security Alarms, L.L.C.
WildBlue Satellite Internet Leasing

Please fill out form below to purchase WildBlue Satellite Internet Service. All information is secure and tested daily by Starfield SSL Certificate. Order by phone - 1 - 877 - 783 - 5169

Customer Information:
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Payment Information: Please enter either Credit Card or Checking Account Information Master Card Visa Discover Credit Card #: Date of Expiration: SVC Code:
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Billing Information: Is the billing address the same as above? Yes No Billing Address: City & State: Zip:		Is this a 1 or 2 story house?
User Name: Password: Mother's Maiden Name: Owner of Residence: Yes No Additional Information:
Package Speed Choices: $49.95 / 512 Kbps $69.95 / 1.0 Mbps $79.95 / 1.5 Mbps
Equip. Leasing monthly cost (choose one): $5.95 per month for 24 mo. 24 month Pre-Paid Lease $99.95
One-time Activation Fee - $149.95. If you order by 12/31/09 / its only $99.95 + S&H (WildBlue will collect within 1-4 days of activation, $50 discount will be shown on your first bill.) Installation Cost - FREE standard installation (current promotion, custom installs will incur additional charge) I have read and agree to Terms and Conditions: By entering your name below will act as your signature. Customer Name: Date: