Customer Contact Information Company Name Contact Name: Address Phone City State Zip SSN: Email Address:

Technical Information: Computer Operating System: Please choose Operating System Windows 95/98 Windows ME Windows 2000 Windows XP Home/Pro Macintosh 7.X Macintosh 8.X Macintosh 9.X Macintosh 10 Linux Unknown DSL Equipment: Please choose DSL Modem CastleNet DSL Router - $75.00 I will get my own gear Phone Number for DSL:

All Pricing subject to availablity*

brightDSL Packages (Please choose a Package)   Package Download Upload Monthly 768KB 768k 128k $29.95 1.5MB 1.5M 384k $49.95 3.0MB 3.0MB 768K $69.95

***If you cancel the service prior to Verizon's Installation or first month's billing, you will still be responsible for the setup fee or any fees charged by Verizon, whichever is greater.

Additional Information: Extra Features Desired: Please choose an Extra Feature Static IP Block of IP Addresses Setup Fee: 1 Year Contract - $75.00 Setup Fee

By clicking on the submit button, you agree to abide by SAA bright.net's Terms and Conditions of Service.  If you have any questions on brightDSL Service, please call 1-888-438-8436 prior to clicking the submit button.  By clicking on the submit button, you are also agreeing to have a credit check run on your account.  If you do not meet our credit requirements a deposit may be required in order to get service installed.  Once you click the button, a brightDSL representative will verify that service is available for you and will contact you.  Service will not be ordered by us until we have made contact with you.