Impulse Internet Services - Serving the California Central Coast since 1995
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DSL Services Pre-Qualification:

If you would like to know if your phone line will qualify for ADSL service, please fill out this pre-qualification form and we will start the process immediately. You are not committing to purchasing any services by filling out this form, it is purely for qualification purposes. If you have any questions, comments or concerns, please contact us.

 
Customer Information (items marked with * are required):
Contact Name: *
Service Type: Residential    Business
Company:
(ONLY if your company is to be billed.)
Address: *
City: *
State:CA
We only offer DSL in California
Zip: *
If you are a residential customer, your HOME phone number is required.
Home Phone:(  )   -  *
If you are a business customer, your WORK phone number is required.
Work Phone:(  )   -  *
ADSL Line:
(The phone # of the line on which ADSL will ride.)		(  )   - 
(add all zeroes for dry loop request)
Are you an existing Impulse customer: Yes    No    Unknown
Username:
(Fill in if you are a current user.)
Email:
Reference:
(How did you hear about our DSL services.)
Comments:
 * required fields
Do you own a NIC:
(NIC = Network Interface Card / Ethernet Card)		 Yes    No
Submit information for DSL qualification:
 

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81 David Love Place, Suite 100 - Santa Barbara, CA 93117