Baldwin LightStream | Applications

Online Application: Residential Service Bundle
ILEC Voice Service with Touch Tone
Cable Video Service with HD Programming - 2 Receivers
High Speed Data - Up to 200Mb Download
Cost: $154.95
(Rate does NOT include broadcaster fees, regulatory fees or taxes)

Full Legal Name:

Date of Birth:

Phone Number:

Alternate Phone Number:

Best Time To Call:

Time of day: ?

Service Address: ?

City:

State:

Zip:

Email:

Co-Applicant

Name:

Date of Birth:

Phone Number:

Email:

Desired Username* ?

Promo Code - (If you have one)

*If your desired username is already taken, you will be notified to make adjustments.

Do you: your residence?

Landlord’s Name ?

Landlord’s Phone

Additional Video Options

Additional High Speed Data Options

DVR Receiver $5.95 /mo. ?

EasyStream WiFi $5.95/mo. (Setup Fee $19.95)

Additional Set-Top Box $4.95/ea. #

Tech Home ?

Premium Movie Channels
HBO $18.95/mo.
Cinemax $13.95/mo.
HBO/Cinemax $26.95/mo.
Starz/Encore $13.95/mo.
Showtime/TMC $13.95/mo.
Playboy TV $15.95/mo.

Static IP Address $15.00/mo. (Setup Fee $20.00) ?

Long Distance Voice Option

Please choose calling features:

Caller ID
Teen Line/Distinct Ring
Cancel Call Waiting
Speed Dial

Caller ID w/ Name
Call Waiting
Caller ID on Call Waiting
3-Way Calling

Initial Residential Install $129.95

This price is general and does not include taxes or other wiring type charges that may apply to your specific install. When promo pricing is available, install rate may be lower.

CUSTOMER PROPRIETARY INFORMATION (CPNI) Please click here for more information on CPNI.

Choose one of the following security questions to answer for your CPNI password.

Type your answer here:

A customer sales and service representative from Baldwin LightStream will contact you within 1-2 business days regarding your order. An install will be scheduled at that time.

I understand that I will be billed a minimum of one month.

I understand prepayment of connection fees and first month service charges are required prior to scheduling install. Other charges may apply.

I agree to Baldwin LightStream’s Internet Acceptable Use Policy and Baldwin LightStream’s Terms and Conditions.

Were you working with a Baldwin LightStream employee prior to filling out this online application?
If so, please enter their name :

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