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Qualify for DSL
Please fill out the following form and click "Submit." We'll get back to you as soon as possible with an answer. Today's date: Your name as it appears on your phone bill: Your address as it appears on your phone bill: Enter the phone number you want the DSL installed on: If you have an alternate telephone number enter it here: Your Telephone Company ( Verizon, PacBell,etc. ): Your E-Mail Address: Additional Comments: Send mail to webmaster@atechno.net with questions or comments about this form.Copyright © 1996-2002 Automated Internet Technologies
Today's date:
Your name as it appears on your phone bill:
Your address as it appears on your phone bill:
If you have an alternate telephone number enter it here:
Your Telephone Company ( Verizon, PacBell,etc. ):
Your E-Mail Address:
Additional Comments:
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