First Name *

Last Name *

Business Name (if applicable)

Address *

City *

Province *

Phone *

Email *

Civic Location, Legal Land Description or GPS Coordinates

Residential Install - Service Questions (Check If Yes)

Do you have an underground sprinkler system?

Are there any pets that may restrict access for our crews or line locators?

Is there any landscaping, walkways, or driveways that may restrict access to your home?

Is there any restricted access to your home due to personal or health reasons?

RFNOW Suitability Assessment Confirmation *

I understand that a site survey will be completed and in some cases my location may not be eligible for free fiber installation.

Signature *

Clear

I understand that RFNOW will mount a grey Network Interface Device box (NID) on the exterior of my home, located near existing telecommunications / power close to the utility room aligned to industry best practices, unless I explicitly inform RFNOW otherwise.

I provide consent to RFNOW to lay the fiber in my property and mount the NID to my house, according to industry standards, without my presence.

By signing this form, you are providing permission to receive the fiber line to your house. This form does not represent an agreement for monthly internet service.