Wi-Fi+ Customer Form

Business Name(Required)

Contact Name(Required)

First Last

Phone(Required)

Email(Required)

Enter Email Confirm Email

Do you have an I.T. associate or I.T. vendor?(Required)

Yes

No

If yes, what is your I.T. contact's name:

I.T. contact phone number:

I.T. contact email:

Do you have a Point-of-Sale system?(Required)

Yes, it is wireless

Yes, it is wired

No point-of-sale system

Do you have more than one Point-of-Sale unit?(Required)

Yes

No

Do you have Wi-Fi dead spots in location?(Required)

Yes

No

If yes, where?

Do you have a Persistent or Static IP?(Required)

Persistent IP

Static IP

Unknown

What is the sq footage of the building?(Required)

Enter a number in feet only:

Current Router and Mesh solution?(Required)

I commit to being on-site and available to answer technician questions during the installation appointment. I also agree to have current network access information readily available.(Required)

Yes

If my schedule changes, I agree to call Smithville to reschedule my appointment if I can no longer be on-site and available to answer technician questions during the installation appointment.(Required)

Yes

My business network has an IP block from a third party.(Required)

Yes

No

Notes or Additional Questions:

Salesperson's First Name:(Required)

Smithville Wi-Fi+ for Business Customer Information

Primary Network Content Policy List

Point-of-Sale Network Content Policy List

Guest Network Content Policy List

Employee Network Content Policy List

Smithville Wi-Fi+ for Business Customer Information

Primary Network Content Policy List

Point-of-Sale Network Content Policy List

Guest Network Content Policy List

Employee Network Content Policy List

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