Dish Application

Door Peninsula Internet, Inc.
sales 743-4999 or 487-9998 support 743-4999 or 487-9998
Dish Application

Get online with Door Peninsula Internet, Inc, Your Door way to smooth sailing on the World Wide Web! Call us from 9 AM to 9 PM weekdays or Saturday from 9 AM to Noon and we'll have you going in no time. To save time you may complete this form and when you hit the submit button it will be emailed to us and we can start working on your activation. Thanks!

Please provide the following contact information:

Name

Title

Organization

Street address

Address (cont.)

City

State/Province

Zip/Postal code

Work Phone

Home Phone

FAX

E-mail

Select your computer's operating system (not currently available for Mac except by networking)

Computer descriptions (make, model, modem type)

Enter your username below. This should be at least three characters but not more than sixteen and should be all lower case. This will also be part of your email address.

Enter a password. This must be at least six characters but not more than eight. The characters must be mixed upper case, lower case and numbers. Do not use punctuation.

Select your plan

      Activation $ 49.
      Equipment $199.
      Check here if USB adapter needed (for laptop) $149.

Spam & Virus Filter (Free - value up to $4.00)
Spam Filter eliminates 95% of unwanted email as well as well know virus/worm attachments.

How I found out about Door Peninsula Internet.

Referrers Name or email address

Select payment method:

Payment by check requires two month advance payment.

Please provide the following ordering information:

BILLING

Credit card

Cardholder name

Card number

Expiration date MM/YY

Choose your setup option ($99. for normal on-site installation)

Installation available from....

	Live Demonstration available at New Century Sturgeon Bay 743-0021 Monday thru Thursday 10:00 a.m. to 5:30 p.m. Friday till 6:00 Saturday 10:00 a.m. to 3:00 by MobileMart on Egg Harbor Road
E-Z Computers	Algoma 487-2699 11am-7pm M-W-F, 9am-5pm T-R, 11-3 Sat. 423 4th Street (click here for map)

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