Mi-Fiber SignUp form Mi-Fiber Sign-Up Fiber and Voice First Name * Last Name * Date of Birth * Format (MM/DD/YYYY) Address * City * State * Zip * Your Fiberhood Do you rent or own the property? * Own Rent Property Owner Name * Phone Number * What is your type of dwelling? * Single Family Home Townhome Condo Apartment Trailer What year was your home built? * I don't know 2020 2019 2018 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 Are you a member of an HOA? * Yes No HOA Name and Phone Number * Is your billing address different than your service address? * Yes No Billing Street Address * Billing City * Billing State * AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY Billing Zip * Email * All correspondence including your service agreement and billing information will be sent to this email address. Home Phone Number * Cell Phone Number Preferred Contact Method * Email Phone . Internet Service Please select your Service Package * PackageDownload and Upload Speeds Up ToMonthly Rate mi-fiber 75 75 mbps$59.95 mi-fiber 200 200 mbps$69.95 mi-fiber 500 500 mbps$79.95 mi-fiber 1000 1,000 mbps (1 Gig!)$99.95 Select Your Router Option * Mi-Fiber Router Equipment Fee $9.95/mo. Includes: static IP, 24/7 Technical Support Line, full maintenance of router, one Wi-Fi access point, and equipment needed to provide the service. Customer Owned Router Equipment Fee $4.95/mo. Includes: static IP, 24/7 Technical Support Line, and equipment needed to provide the service. Mi-Fiber Router Add-ons * Add Tech Home Protect for $4.95/month (Learn More) Add Tech Home Protect Plus for $9.95/month (Learn More) Add Managed Wi-Fi Service for only $10 more per month (Learn More)Total of $19.95/month includes Equipment Fee and Tech Home Protect, in addition to Managed Wi-Fi Service. Add Tech Home Support for only $15 more per month (Learn More) Total of $24.95/month includes Equipment Fee and Managed Wi-Fi Service in addition to Tech Home Support features. Additional access points are available for $7.50/month/device. No thank you Customer owned router equipment Add-ons * Add Tech Home Protect for $4.95/month (Learn More) Add Tech Home Protect Plus for $9.95/month (Learn More) No thank you All advertised speeds may not be available in all locations. Call for more information. *One year Service Agreement required. We will email the Service Agreement for your electronic signature before you schedule your installation. Additional IP Address * No Thank You 1 Usable IP Address - $16.00/month 5 Usable IP Addresses - $32.00/month (required for any Customer-owned equipment that needs a public IP address - contact Mi-Fiber to discuss or if more IPs are needed) Voice Service Mi-Fiber is happy to offer Aureon Voice Service for $20.00 per line/month! * Yes, I'm interested in Aureon Voice Service! Not at this time. Installation Details: A non-recurring installation fee of $100 will apply but will be discounted to $70 if Aureon Voice is installed at the same time as Mi-Fiber Internet (total fee of $170 for installation of voice and Internet simultaneously). Standard installation includes one phone/Analog Telephone Adapter (ATA) at the router. Installation of any other phones or equipment during initial installation will be billed at time and material. How many phone lines do you need? 1 2 3 4 5 Long distance charges are billed at $.06 per minute. Additional charges apply for directory assistance and operator assisted calls. * Yes, I agree to the Long distance charges listed above. In addition to Mi-Fiber Aureon Voice service, Mi-Fiber also offers fax lines. * Yes, I'm interested in Mi-Fiber Aureon Traditional Fax Line for $25.00/month Yes, I'm interested in fax to Email service for $7.99/month No Thank You How many traditional fax lines do you need? 1 2 3 4 5 How many fax to email services do you need? 1 2 3 4 5 Equipment Purchased (required) * ATA - Cisco Small Business VoIP Adapter $79.95 Equipment Purchase (optional) AT&T Corded Speakerphone with Caller ID/Call Waiting White $29.95 Future Call Big Button Corded Telephone White $32.95 Panasonic Cordless Telephone 1 Handset Black $37.95 Panasonic Cordless Telephone w/ Digital Answering Machine 2 Handsets Blk $63.95 AT&T 2-Line Corded Telephone without Answering System Black $71.95 Maintenance Service Agreement The minimum term for ATA Maintenance service agreement is 1 year, beginning on the Service Installation date. ATA Maintenance Service Agreement $3.00/month NOTE! Fiber optic services and Voice over IP (VoIP) require backup power to continue functioning during a power outage. To minimize disruption of Service during an outage, Mi-Fiber offers the following uninterruptible power supplies (UPS) with limited battery backup capability. Uninterruptible Power Supply Options (Optional)ATA Maintenance Service Agreement $3.00/month Please let us know how many UPS units you require. Bill Pay Options & Additional Information Bill Pay Options * Email Bill Notice and Auto Pay via Checking Acct Email Bill Notice and Auto Pay via Credit or Debit Card Email Bill Notice and Mail Payment How did you hear about Mi-Fiber? * Please select an option Website Email Direct Mail Billboard Yard Sign Vehicle Decal Radio Advertisement TV News Story Waukee Living Dallas County Today A Friend Twitter Facebook Public Event Realtor TV Commercial Spotify School District How did you hear about Mi-Fiber? Brokerage/Realtor * Aurora Business Park Autumn Ridge Apartments Bryan Clark Homes Buyers Realty Central Iowa homes CENTURY 21 Signature Real Estate - Urbandale Coldwell Banker Mid-America Group - Robin von Gillern Comito Barb Conlin Properties DSM Home Sources - Andrew DePhillips EXIT Realty Capital City Ferguson Commercial Real Estate Services FSBOHomes.com Goodall Properties Hubbell Realty Company Hubble Realty Hurd Real Estate Services Iowa Association of REALTORS Iowa Realty - Kevin Howe Iowa Realty - Waukee/Adel office Iowa Realty Adel Ironwood Homes Jude Sellner Keller Williams Realty Greater Des Moines Knapp Properties Knapp Properties Inc Makohoniuk Real Estate Next Generation Realty Next Generation Realty Inc - Harvey Tom Peoples Company Re/MAX Precision RE/MAX Real Estate Concepts - Heather Wright RE/MAX Real Estate Group Re/Max West Realty Realty Xperts Signature Commercial Real Estate Signature Real Estate Space Simply - Neil Timmins Stanbrough Realty Company, LLC Terrus Real Estate Group The Siedenburg Group Twenty/20 Real Estate VIA Group Realtors Other Let us know who told you about us. * Mi-Fiber yard signs are a great way to increase interest in your area. Would you like to have a sign placed in your yard? * Yes, Please put a sign in my yard No, Thanks Please write in anything that our construction crews need to be aware of in your yard. (Dog Fence, Sprinkler System, etc) Terms and Conditions * I agree to Terms and Conditions Submit If you are human, leave this field blank.