RESIDENTIAL INTEREST FORM

Submit early sign up for services now!

Please note that service installation will not take place for 2-4 months.

If you have previously submitted an Interest Form or

think your address needs reviewed,

please click here.

Chkpt - Conxxus Fiber Early Signup

We're excited to bring you fast, affordable, and reliable fiber internet!
Please begin the process by filling out the form below. You'll select your Internet speed below. You may also add a video and phone package. Please note service installation will not occur for 2-4 months

First Name *

Last Name *

Date of Birth

Primary Phone Number *

Secondary Phone Number

Email Address (All correspondence including your service agreement, installation scheduler, and billing information will be sent to this email address.) *

Service Address *

City *

State *

Zip *

Your Fiberhood

Is your billing address different from your service address? *

Yes, they are different.

No, they are the same.

Billing Street Address *

Billing City *

Billing State *

Billing Zip *

Do you rent or own the property where you are looking for service?

Rent

Own

Landlord Name

Landlord Email

Landlord Phone Number

Is this a residence address or a business?

Residence

Business

If you have selected BUSINESS, DO NOT continue filling out this form. Click here to be directed to the Business Form.