Internet Order Form

This form will allow you to order DSL or Fiber service.

The pricelist is available at www.brandx.net

Please feel free to call us at 310 395 5500 with any questions, or to sign up via telephone.

First Name:

Last Name:

Address:

Email:

Telephone:

Current Service

Do you currently have Internet service?

DSL Uverse FIOS Cable No

Local Telephone Provider

What company owns the phone lines in your neighborhood? If you are not sure, you can refer to the Telco Service Areas Map.

If you area not sure which one applies, make your best guess and our orders department will find out for you.

Frontier Verizon AT&T Not Sure

Who is your current internet provider?

Desired Service Type

Please select the type of service you would like from the lists below.

Frontier Area Fast DSL

In Frontier areas we will give you the best speed that the line will support, up to 12 mb. In some areas 18 and 24 mb are also available.

There is a $60 startup fee waived if you choose the annual plan.

Frontier area DSL service: Select Frontier 12 mb Annual ($45) Frontier 12 mb Monthly ($45 + $60 install) Frontier 18 mb Annual ($50) Frontier 18 mb Monthly ($50 + $60 install) Frontier 24 mb Annual ($55) Frontier 24 mb Monthly ($55 + $60 install)

Frontier Area Fiber Services

Fiber is available at some locations. There is a $60 turn on fee which is waived if you choose the annual plan.

Frontier Area Fiber Service: Select Frontier 25/25 mb Fiber annual ($45) Frontier 25/25 mb Fiber monthly ($45 + $60 install)

Verizon Area Services

Check our Verizon area pricelist. This pricelist applies to customers in current Verizon areas such as New York.

There is a $60 turn on fee, but no telephone line and no contract are required.

Verizon area services: Select Verizon 0.75 mb ($25) Verizon 1.0 mb ($28) Verizon 1.5 mb ($35) Verizon 3.0 mb ($45) Verizon 5.0 mb ($60) Verizon 7.1 mb ($75)

Equipment

A modem and a router are required for your connection. If you already have them, great. If not, we can supply them for you.

Check our Equipment pricelist

I have a modem I need a modem ($30)

I have a router I need a router ($45)

Billing Information

Card Number:

Card Expiration:

CCV:

Comments

Use this area to add any comments or questions