Are you a current Wave Broadband Subscriber : Yes No
Are you a current OlyPen Customer : Yes No If YES, what is your username:

Contact Name :
Contact Phone :
Street Address : No PO Box Please
City :
Postal Code :

Service Speed Option :

Low Speed (256kb/56kb) $24.95/mo
Mid Speed (1.5mb/256kb) $34.95/mo ($25 w/ T.V.)
High Speed (6mb/384kb) $44.95/mo ($35 w/ T.V.)
Power User (10mb/768kb) $54.95/mo ($45 w/ T.V.)
Power User Plus (10mb/1.5mb) $64.95/mo ($55.00 w/ T.V.)

Modem Billing Option*: Rent Purchase

Modem Type Option*: Standard Cable Modem Wireless Ready Cable Modem/Router * Note:
Standard Cable Modem $70.00 purchase or $3.00/month rent
Wireless Cable Router $110.00 purchase or $5.00/month rent

Customer Notes :

OlyPen Promotional Code :
If provided