A-1 ISP Services Selected
Customer ID _______ Application Date _________
Company Name _________________

Initial Service Choice

This initial setup fee is a required pre-requisite to any other A-1 ISP service.

Platinum Package Pricing
Setup Fee: 75.00, Monthly Minimum Fee: 75.00 

Additional Service Add-Ons

These services can be added on at any time. 
Email/Web space Services Yes No (circle one)
Setup Fee: 75.00, Monthly Fee: 100.00 

I hereby authorize A-1 Internet Service Provider to activate these services and agree I am bound to all conditions and restrictions described within the Terms of Service agreements. 

Signature Required: ____________________________ Date: _____________ 


SET UP FEES MUST BE PAID IN FULL PRIOR TO ACTIVATION OF SERVICES

A-1 Internet Service Provider
PO Box 1333
El Cajon, CA 92022
(877)442-1477 Voice
www.a1wholesale.net / sales@a1wholesale.net