In order for us to put in an order for Qwest DSL services, we need the following information. This information is only for the use of Grand County Internet Services and our installers to determine if services can be provided now or in the future. It will not be shared with any other parties. Please fill out the form as completely as possible!
Service Type (Billed Directly from Qwest): We recommend 256K but the promotional pricing of 1.5M looks nice at this time. Speeds can be changed at any time by notifying Qwest. There may be a small service charge for changing speeds.
Note Qwest has promotiuonal pricing for 1st year on 1.5M is $22 per month then $28.
256Kbs down /256Kbs up - Qwest charges $15.00 per month plus applicable taxes. 1.5Mbs down /800Kbs up - Qwest charges $22.00 per month plus applicable taxes. Standalone DSL - No telephone 1.5Mbs down /800Kbs up - Qwest charges $27.00 per month plus applicable taxes.
Modem Plan (Billed Directly from Qwest): We recommend buying the modem. This is not a wireless modem but we can install a wireless router behind it if wanted ($50). Please fill in the comments section if in office wireless wanted and order a GCIS installer. Buy Modem - Approximately $69.98 including shipping Lease Modem - $5.00 per month +$9.99 shipping I already have a Qwest certified modem and do not need one
Addition Filter Kits: Every phone in the house or business must have a filter placed between it and the wall. The modem contains 3 additional filters. You will need to order a filter kit for every 3 phones you have above the initial 4 phones.
I do not need an additional filter kit I will need 1 additional filter kit as I have over 4 phones I will need 2 additional filter kits as I have over 7 phones I will need 3 additional filter kit as I have over 10 phones
Qwest Installation - Normally the DSL modem can be installed without a telephone person visiting your house or Business. If you have multiple lines or telephone equipment for switchboard purposes then it will probably be best to schedule a Qwest installer. The Qwest installer will just insure the DSL modem is working and does no computer setup.
No I don't think I will need a Qwest installer Yes I want a Qwest installer ($69.99)
GCIS Installation: The DSL modem may be self installed and we can walk thru this on the telephone line. However, if you have multiple machines or special needs, we recommend having our installer do the installation. Our install cost is $60 for the first hour and does not include any addition equipment or supplies. Any install over 1 hour will be billed at $40 per hour plus equipment and supplies.
I will try the self install with you Please send our a GCIS installer to help me setup everything Please send our a GCIS installer with Wireless router ($50)
Internet Service Plan: Grand County Internet services bills on a yearly basis at $180 for the year (averages $15 per month). This will be paid at time of install unless other arrangements have been made. Other payment plans are available. If you should cancel prior to one year - unused periods will be prorated and refunded. We have flexible plans for part-timers if needed. When ordered thru this form, a $40 credit will be applied for 1st year. Standard Plan -1 email, local dialup backup, no public IP address pay yearly $180 Premium Plan -1 email, local dialup backup, no public IP address, nationwide travel dialup account pay yearly $240 Basic Plan -No email, no dialup backup, no public IP address pay yearly $120 Standard Plan -1 email, local dialup backup, no public IP address pay monthly $22 Premium Plan -1 email, local dialup backup, no public IP address, nationwide travel dialup account - pay monthly $25 Basic Plan -No email, no dialup backup, no public IP address pay monthly $15
Additional options:
Public IP address $60 per year prepaid
Additional Email accounts at $24 per year if paying yearly or $3 per month if paying monthly
Date you would like the DSL service to start:
Names - should be same as Qwest billing if not indicate both names:
Qwest Billing Account name Qwest account number(3 digits following telephone number on bill) or last four digits of Social Security number of the person who owns the account
Name of Person placing this order
Billing address: Physical Address where modem is to be installed: Shipping address for modem if different (no PO Box- will normally go to physical address where the DSL is to be installed): Primary telephone number that DSL will be placed on to including area code: Any other telephone numbers on the premises where DSL will be installed: (just in case your primary number does not qualify, we will test these other numbers)
I may need to talk to you if there are any questions - please furnish any and all means I can contact you: Email address: note that a copy of this order will be sent to you for verification telephone numbers or additional means to reach you If not in a town give a detailed description of where you are and driving instructions to reach you. Please be detailed if you are not in town Any other comments or Questions?
It takes anywhere from 1 week to 10 days for Qwest to fulfill the order and send you the modem. We will send you our information and schedule an install on or about the day the service is to start assuming the Modem has been received.Thank you for your interest and we will get back to you shortly on the possibilities.