WARNING: This form is for ORDER only, click here to CHECK for availability
PubNIX, Inc. - xDSL Order Request
EMail of requestor:
print("value=\"$email\">\n");
Customer Contact Name:
print("value=\"$contact\">\n");
Customer Contact Phone Number:
print("value=\"$contact_phone\">\n");
Civic Number:
Do not forget about Appt | Suite #
print("value=\"$civic_number\">\n");
Street Name:
print("value=\"$street_name\">\n");
Town:
print ("value=\"$town\">");
Postal Code:
print ("value=\"$postal_code\">\n");
Phone Number:
print ("value=\"$phone_number\">\n");
Must be the phone number corresponding to a phyiscal phone line.
Service Type:
Residential 3Mbps/800Kbps - PPPoE - Unlimited
Residential 4Mbps/800Kbps - PPPoE - 10GB
Residential 4Mbps/800Kbps - PPPoE - Unlimited
Residential 4Mbps/800Kbps - VLAN - 10GB
Residential 4Mbps/800Kbps - VLAN - Unlimited
Commercial 3Mbps/800Kbps - PPPoE - 10GB
Commercial 3Mbps/800Kbps - PPPoE - Unlimited
Commercial 4Mbps/800Kbps - PPPoE - 10GB
Commercial 4Mbps/800Kbps - PPPoE - Unlimitied
Commercial 4Mbps/800Kbps - VLAN - 10GB
Commercial 4Mbps/800Kbps - VLAN - Unlimitied
Commercial Telus 2Mbps/800Kbps
Commercial Telus 4Mbps/800Kbps
Commercial Telus 6Mbps/1.5Mbps
Note: