Thank you for visiting Pine Tree Networks. Please fill out this form to request Broadband Internet service.

* indicates a required field

Contact Information

Name: *
Current Email:
Billing phone no.: *
Physical street address: *
Contact name: (if different from above)
Phone number where you can be reached: *
Best time to contact you:

Computer Information

Computer type:*	PC Mac
Operating System:* (minimum system requirements apply CLICK HERE)	Windows or   Mac Version:
Does your computer have an Ethernet Port?* (requirement for service)	Yes No I will have one installed
Does your home have an alarm system?* (alarm systems require a special filter)	Yes    No

Service Information

Service type:*	Residential Business
Service plan:*	Always On SecureSpeed SecureSpeed Plus SecureSpeed XT Secure Speed Professsional
Installation:*	Self Installation Kit Professional Installation

Email accounts

If you requested SecureSpeed XT you may choose up to eight email accounts. You may choose up to six accounts at the time of installation for SecureSpeed Plus. Please provide a USER ID and PASSWORD for each email account you wish to activate. If you are requesting SecureSpeed Professional, a service representative will contact you for the additional USER ID and PASSWORDS.
Email account #1 USER ID PASSWORD   Email account #3 USER ID PASSWORD Email account #5 USER ID PASSWORD Email account #7 USER ID PASSWORD	Email account #2 USER ID PASSWORD   Email account #4 USER ID PASSWORD Email account #6 USER ID PASSWORD Email account #8 USER ID PASSWORD
USER ID can be up to 14 lowercase letters and can not start with punctuation. PASSWORDS can be any combo of letters, numbers and symbols. No more than eight characters.