DSL Order Form

Please fill out the below details so Centauri can process your DSL order. Once received a sales associate will verify the install date and contact you with the details. Make sure the house phone number below is the DSL service number.

You must have an AT&T phone number as the DSL-Phone to use our service. Must also keep the phone active with AT&T at all times or the service will be interrupted.

General Information:

First Name:   Last Name:
Service Address
City: State: Zip:

Internet DSL speeds :

Select DSL service speed Pricing Options
6.0 Mbps -------------------------------------------> $37.95 Includes dynamic IP Address
3.0 Mbps -------------------------------------------> $29.95 Includes dynamic IP Address
1.5 Mbps -------------------------------------------> $25.95 Includes dynamic IP Address
768 K -----------------------------------------------> $21.95 Includes dynamic IP Address


Centauri provided DSL Modem?
  Yes -------> $119.95 Dlink ADSL 2640B Modem / 3-IN-1 Wireless Router
No --------> $0.00 Customer provides DSL Modem