EmailMeForm
Application for Fiber (Residential)
Jade Communications, LLC
129 Santa Fe Avenue
Alamosa, CO 81101
Please complete and submit the application below for Fiber Internet/Digital Phone service.
All fields are secure.
Do you currently have an account with Jade Communications?
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If you already have Internet or Digital Phone with us, converting you to JadeFiber saves you time and boosts your speed!
Name
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First
Last
Cell Phone Number
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Alternate Person Phone Number
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Email
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Mailing Address
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Street Address
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City
State / Province / Region
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Lebanon
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Nepal
Oman
Pakistan
Palestine
Philippines
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Russia
Saudi Arabia
Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Democratic Republic of the Congo
Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country / Region
Physical Address (if different)
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Aruba
Bahamas
Barbados
Belize
Canada
Cayman Islands
Cook Islands
Costa Rica
Cuba
Dominica
Dominican Republic
El Salvador
Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Netherlands Antilles
Nicaragua
Panama
Puerto Rico
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Trinidad and Tobago
United States
Argentina
Bolivia
Brazil
Chile
Colombia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Kosovo
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
Vatican City
Afghanistan
Bahrain
Bangladesh
Bhutan
Brunei Darussalam
Myanmar
Cambodia
China
East Timor
Hong Kong
India
Indonesia
Iran
Iraq
Israel
Japan
Jordan
Kazakhstan
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Lebanon
Malaysia
Maldives
Mongolia
Nepal
Oman
Pakistan
Palestine
Philippines
Qatar
Russia
Saudi Arabia
Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Democratic Republic of the Congo
Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country / Region
Please Provide Driving Directions (from Alamosa) to Your Location.
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Please include streets, building color, and any identifiable landmarks.
Building Ownership
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Choose one
I own the location where I want service
I rent the location where I want service
Due to modifications that may be made during the installation process, applicants who do not own the location where service is requested must receive written permission from their landlord/leasing agency before services can be installed.
Please Attach a Copy of the Written Consent Signed by Your Landlord/Leasing Agency
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This attachment needs to include: Tenant Name, Tenant Address, Landlord Name, & Landlord Signature. Attachments without these components will not be processed.
Date of Birth
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DD
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YYYY
Social Security Number
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A valid and complete social security number is required for service
Driver's License Number
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A valid driver's license number is required for service
Driver's Licence State
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Choose one
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Please Attach an Image of Your Driver's License
Place of Employment & Employer Contact Information
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Account Security Information Part 1
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Choose one
What High School did you attend?
Where were you born (city/state)?
Please select and answer one of the security questions in this dropdown; this information is used to protect and secure your account.
What High School did you attend?
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Where were you born (city/state)?
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Account Security Information Part 2
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Choose one
What is your mother's maiden name?
What is the first name of your Grandfather?
Please select and answer one of the security questions in this dropdown; this information is used to protect and secure your account.
What is your mother's maiden name?
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What is the first name of your Grandfather?
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Account Security Information Part 3
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Choose one
Where was your favorite place to go as a kid?
What is your favorite pastime?
What is the name of your favorite pet?
Please select and answer one of the security questions in this dropdown; this information is used to protect and secure your account.
Where was your favorite place to go as a kid?
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What is your favorite pastime?
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What is the name of your favorite pet?
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Start Date for Service
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Generally, Internet & digital phone services are installed within 3-4 business days.
Please Select Your Desired Internet Speed
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Choose one
Residential: 25 Mbps down/25 Mbps up ($39.99/month)
Residential: 50 Mbps down/50 Mbps up ($49.99/month)
Residential: 100 Mbps down/100 Mbps up ($79.99/month)
Residential: 1 Gig down/1 Gig up ($124.99/monthly)
For a limited time only, all fiber installations are free.
Router Features
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Choose one
Rent router from Jade Communications ($4.99/month)
Purchase router from Jade Communications ($110.00)
I own my own router and would like to use it for service
Routers are used to connect multiple devices within your network
Technology Security Software
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Choose one
Protect ($5.99 monthly)
Protect Plus ($9.99 monthly)
Support Plus ($14.99 monthly)
I am not interested in security software at this time
Installation fee for all packages is $14.95.
JadeTV
I would like JadeTV ($24.99/month)
Featuring 11 local channels, the ability to pause, rewind, and fast forward live TV, and streaming on Apple, Roku, and Android devices, JadeTV is a low cost HD alternative to traditional satellite TV.
Please Select a Roku for your JadeTV
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Choose one
Roku Streaming Stick ($4.99/month)
Roku 1 ($4.99/month)
Roku 4 ($9.99/month)
I am not interested in renting a Roku at this time
Equipped with lightening fast processors, Roku offers endless streaming possibilities for you and your family. All Roku models come with live tech support, lifetime warranty, and replacement protection.
JadeTV Password
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Choose a password for your JadeTV.
This password allows you to access content.
JadeTV Installation
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Choose one
I'll install JadeTV myself
I'd like Jade Communications to install JadeTV ($49.99)
Install fees: $49.99 for Jade Communications to install JadeTV on one device and an additional $19.99 for each additional device.
Digital Phone
I would like digital phone bundled with my internet package ($19.99/month)
With unlimited long distance calling in the continental United States and features including call forwarding, call waiting, speed dialing, conference calling, caller ID, and voicemail, digital phone is a landline phone that transmits your voice via the internet.
Telephone Listing
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I do not want to be listed in the Telephone Directory ($.50/month)
I would like to be listed in the Telephone Directory (included in package)
Telephone Publishing
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I do not want to be published in the Telephone Directory nor would I like my number to be available for Directory Assistance ($.50/month)
I would like to be published in the Telephone Directory & have my number be available for Directory Assistance (included in package)
I Would Like to be Listed in the Telephone Directory & Published as
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The name in this field will be listed in the local Telephone Directory and will be accessible by Directory Assistance.
Telephone Porting
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I do not want to port my number from my current provider and I would like a new number
I would like to port my number from my current provider
If you would like to port your telephone number, please do not disconnect your service with your current provider. The service will be automatically disconnected once the phone is ported.
Please Attach a Copy of Your Current Phone Bill
Add File
A copy of your current telephone bill is required to port your number over to our system. You can submit it here or bring it into our office. Service will not be activated until the bill is received.
Advanced Features
Automatic Call Back ($1.00/month + $5.00 installation)
Automatic Line ($1.00/month + $5.00 installation)
Automatic Recall ($1.00/month + $5.00 installation)
Call Forward Busy ($1.00/month + $5.00 installation)
Call Forward Don't Answer ($1.00/month + $5.00 installation)
Cancel Call Waiting ($1.00/month + $5.00 installation)
Customer Originated Trace ($1.00/call)
Deny Originating ($1.00/month + $5.00 installation)
Deny Terminating ($1.00/month + $5.00 installation)
Don't Answer Transfer ($1.00/month + $5.00 installation)
Find me ($1.00/month + $5.00 installation)
Originating Call Management/Toll Restriction ($1.00/month + $5.00 installation)
Ring Again ($1.00/month + $5.00 installation)
Selective Call Acceptance ($1.00/month + $5.00 installation)
Special Billing ($1.00/month + $5.00 installation)
Suppression ($1.00/month + $5.00 installation)
Terminating Call Manager ($1.00/month + $5.00 installation)
User Transfer ($1.00/month + $5.00 installation)
Warm Line ($1.00/month + $5.00 installation)
Advanced features can be added for a monthly charge and a one time installation fee.
Battery Backup Agreement
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I acknowledge that Jade Communications will provide the first set of backup batteries. After this, I am responsible for the upkeep of batteries for as long as I have service ($45/battery)
Battery backup packages are available to ensure that you'll be able to reach 911 during a power outage. They also allow for your Internet/Phone/TV/E-mail to work during a power outage.
Payment information
I would like to add my payment information for $5.00 off my first month of service
Promotion valid for a limited time only. Terms & conditions may apply.
Name of Bank
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Name on Account
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Bank Routing Number
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Bank Account Number
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Jade Communications will automatically charge this bank account number for the amount of your bill on the 5th day of every month.
How did you hear about us?
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Choose one
Friend/neighbor
Door knocker/flyer
Grocery store
Newsletter
Newspaper
Online
Other
We're locally owned and operated and would like to know how you heard about us.
Please specify:
Special Notes
If someone referred you (must be a current customer), please enter "Refer A Friend: [you friend's name]" in the field above.
Digital Phone Disclaimer
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I have read and agree to the Disclaimer outlined below
Jade Communications Digital Phone will not function (regular or 911 calls) if Jade’s equipment fails or is relocated from the current premises or tampered by the customer. Additionally, regular calls and 911 calls will not function if the Jade equipment is interrupted or not functioning for any reason or if the customer’s power is non-functional. This may include, but is not limited to, power outages lasting beyond the current backup provided by Jade Communications or network outages.
The service agreement is violated if the customer’s equipment is moved from the physical location where it was originally installed.The customer is completely responsible for all power at the customer’s location. Since power outages do occur, Jade Communications recommends that an Uninterrupted Power Supply, and surge arrestor be purchased, installed and maintained on the high speed internet circuit which is connected to the ATA and telephone. All wires from other telephone companies connected at the interface box located outside must be disconnected.
Be advised that any services provided through this equipment are not intended to replace or be a substitute for primary line voice services or Plain Old Telephone Service (POTS) and are not meant to provide guaranteed 911 or E911 services or to permit access to 411 directory assistance services. Your service provider, not Motorola, is responsible for the provision of Voice over IP (VOIP) telephony services through this equipment. Motorola shall not be liable for, and expressly disclaims, any direct or indirect liabilities, damages, losses, claims, demands, actions, causes of action, risks, or harms arising from or related to the services provided through this equipment. Important: be aware that you will not be able to make any calls using this Voice over IP (VOIP) device if your broadband connection is not functioning properly. You will also not be able to make any calls using this Voice over IP (VOIP) device if you have lost electrical power.
Terms & Conditions
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I have read and agree to the terms & conditions outlined below
I agree to a credit check which is required for service.
I acknowledge that if I do not pass the required credit check, a deposit is required for service.
I agree to pay Jade Communications the entirety of the installation fee prior to installation.
I understand that all equipment used for service belongs to Jade Communications. Any damage incurred by the equipment at the customer's location is the sole responsibility of the customer.
I agree to pay a $95.00 equipment retrieval fee, if the equipment is not returned after 10 days of disconnect.
I agree to pay all charges within 10 days of issuance and to pay all reasonable costs of any collection agency (up to 50% of the outstanding bill), attorney, court or other miscellaneous fees used to collect the past due amounts.
Paperless Billing
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I would to have my monthly bill emailed to me
I would prefer to have my monthly bill mailed to me
Get your full monthly bill right to your email inbox instead of in the mail.
Information Verification
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I swear, under penalty of perjury, that all the above information is correct and accurate
By checking this box, I acknowledge that the information provided in this application is factual and true.