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SETEL
First Name *
Last Name *
Email *
Phone Number *
Best Time to Contact You *
I prefer to be contacted by: *
911 Street Address *
Address Line 2 (Suite #, Lot #, Apt #)
City *
State *
Zip Code *
Mailing Address *
Address Line 2 (Suite #, Lot #, Apt #)
City *
State *
Zip Code *
Date of Birth *
MM
/
DD
/
YYYY
Internet Service Plan *
IPTV Service Plan *
Required
Number of TV's (each TV requires a set top box) *
TV Add Ons *
Required
Phone Line Count ($30/Line) *
Would you like a SETEL provided Voicemail? *
I currently have phone numbers I would like to move from another provider to SETEL. Please provide all numbers below. *
Porting Charge (This charge is to move your current phone number from your old provider to SETEL)
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All phone service is delivered digitally (VoIP). Any 3rd party systems need to be cellular or IP. Ex: Alarm System, credit card machine, modem. *
Installation *
Security Pin ( 6 digit) *
Security Question (What is the name of the town you were born in?) *
Regulatory Agreement *
Required
Move in Date *
MM
/
DD
/
YYYY
Taxes and Surcharges
Taxes and Surcharges Additional
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