HughesNet Satellite Internet - Service Request Form

Montana Satellite & Wireless

"Satellite Entertainment & Communications"

Proudly Serving Montana, USA... and the rest of the World!

Toll Free Phone / Fax: 1-888-608-2299

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HughesNet High Speed Satellite Internet Systems and Services

This form can be used to setup your HughesNet monthly service account for new and used HughesNet DW7000 or HN7000S Equipment as well as to submit information to us necessary to place your order for one of the new HN9000 Ka Band Satellite Internet Systems.

If you have purchased your equipment from Montana Satellite & Wireless, this service is FREE!

If you have not purchased equipment from us, there is a $ 35.00 charge for this service!

Please click here to submit payment for this service if you haven't already done so!

We will inform you of which satellite your account is / was assigned to when we send you your HughesNet site account number and PIN. If you are unable to connect to the default satellite and wish to change to a different satellite, you will need to fill out our Satellite Change Request Form and we will process a satellite change request through HughesNet on your behalf. There is a $50.00 one-time charge for this service which will be billed to the credit card you submit on that form.

HughesNet / DirecWay Satellite Based Commissioning Rules - Effective from 11/18/08 - Download

HughesNet / DirecWay Satellite Based Commissioning File (SBC File for modem) - Effective 08/28/08 - Download

At this time we cannot offer "used equipment accounts" for the DW6000 or the new HN9000!
If you have a DW6000 you must contact HughesNet Sales @ 866-347-3292 to have them setup the account for you.

EQUIPMENT:

MONTHLY SERVICE PLAN:

SERVICE OPTIONS:

Option - Maintenance Plan - Available with new equipment activations only!

Option - Dial-up account

INSTALLATION INFORMATION

First Name:
Middle Name:
Last Name:

Company Name: (can be a business name or full name... example: John Doe... or Doe Plumbing, etc.)

Installation Address:
Installation Address:

Installation City: Installation State: Installation Zip:

Installation Phone: Installation Phone: E-mail Address:

BILLING INFORMATION (must be the same as the credit card billing address)

Check here if same as Installation Information (no need to fill out this section if you check the box)

First Name:

Middle Name:

Last Name:

Billing Address:

Billing City: Billing State: Billing Zip:

Billing Phone: Billing Phone: E-mail address:

Approximate Installation / Activation Date: AM PM

Please choose a 4 digit PIN Number for your new HughesNet Account: (will default to the last four digits of your primary phone number)

Site Name: (use to differentiate from other systems you may have under your name, etc.... example: Lake House)

PAYMENT INFORMATION
If you do not want to submit your CC information online, please contact us toll free at 888-608-2299 to provide that information!

This information will be used for your monthly service billing by HughesNet for your monthly Internet access.

Credit Card Type: (required for monthly billing)

Credit Card Number: Credit Card Expiration Date: (format: 01/06 or 01/10/06)

Name as it appears on card: Credit Card Security Code: (last 3 digits on back of card or the 4 on front if AMEX)

Please select from the following that best describe your equipment and installation status:

Installation Status: I have the system installed already I am in need of installation services

(If you are a a re-seller or installer, please fill in your name or company so that we can match this account up to be "your customer" in our system.)

The above information will be used by Montana Satellite & Wireless to setup your HughesNet Monthly Service account only. We will not offer your information to anyone other than HughesNet. Montana Satellite & Wireless is not responsible for HughesNet service, and by submitting this information, you agree to the HughesNet Terms and Conditions and to any contractual service obligations, etc.

By submitting this information, you must agree that you are submitting the above information as fact and that you are the individual requesting HughesNet service and that you are authorized to use the credit card information being provided. You also understand that any fraudulent or misleading information may result in a suspension of your HughesNet service and possible legal remedies.

If your equipment was purchased from someone other than Montana Satellite & Wireless, a $35 (or $ 50.00 if DW6000) charge will be applied to the credit card above for this account setup service that you are requesting unless other arrangements have been made.

If the above statements and information is true and correct, please press submit. We will contact you via the e-mail address or telephone number submitted with your new account information and to schedule the sales, and/or installation of your system if requested.

Thank you!

• Overview • Features & Concerns • Requirements • Equipment • Monthly Service • Installation • Upgrades • Rebates • HughesNet Service Request Form • HughesNet Order Form • Satellite Change Request Form • Rental • Support • FAQ •

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