KCI Application Form Please enable JavaScript in your browser to complete this form.Date Name *FirstLastEmail *Alt Contact *Phone *Alternative Phone # *Referred By: Friend, Neighbor, Existing Customer Referral Do you own or rent? *Own RentIf renting, you must obtain a letter of permission for us to be on the property to do an estimate or install your service.Mailing Address *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhysical Address *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeInternet - Residential*Turquoise- 50 Mbps - $49.90/moSilver-100 Mbps - $59.90/moGold- 150 Mbps - $109.90/moDiamond- 250 Mbps - $152.90/moBrass - 400 Mbps - $165.90/mo*All prices subject to change & do not include installation, taxes or applicable fees. Telephone Services - Residential* $38.87 including taxes + fees for Residential Line $10.00+ taxes & fees for Second Residential Line $10.00 off when bundled with Internet services*All prices subject to change & do not include installation, taxes or applicable fees. Internet - Business*Turquoise- 50 Mbps - $83.90/moSilver- 100 Mbps - $103.90/moGold- 150 Mbps - $143.90/moDiamond- 250 Mbps - $173.90/moBrass- 400 Mbps - $189.90/mo*All prices subject to change & do not include installation, taxes or applicable fees.Telephone Services - Business*$51.06 including taxes + fees for Business line$10.00 + taxes & fees for Second Business Line *All prices subject to change & do not include installation, taxes or applicable fees.Comment or Message1. Are there any animals on the property that we need'to be aware of? *2. Is there any equipment outside that can't be reached without encroaching on the neighbor's property? *3. Is there any landscaping that must be removed prior to construction? *4. Are there any unsafe or unsanitary areas on or near the location? *5. Are there any locked gates or fences that we must have access to? *CheckboxesAll prices subject to change & do not include installation, taxes or applicable fees. Kit Carson Internet bill is not included with electric bill. By submitting this application, customer is allowing KCI to enter property for estimate.Email *MessageSubmit Application
