Name:

Street Address:

Billing Address:

City:

Telephone (Daytime):

Telephone (Evening):

Are you currently a Southern VT Cable customer?
Yes No A minimum of Basic Cable service is required for the Internet.

Desired Level of Service:
640 Kbps *If you are unsure, select this option.
1.5 Mbps
4 Mbps

Desired email address:
@SVCABLE.NET
You may have upto 5 email addresses per account.

How many computers will you be connecting to the service?
1 2 3+ *Additional computers may require a router.

Is this a business or residence?
Residence Business

Would you like more information on our wireless Internet package?
Yes No

If you have any questions or comments, please let us know here: