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Tell us whatís important to you.


Hereís your first step toward getting the unparalleled service of BlinkTV, BlinkInternet and BlinkPhoneÖ and saving money, too! Just complete this quick form, and the BlinkBundle professionals will develop an affordable package thatís tailored to your lifestyle. Of course, thereís absolutely no obligation, and youíre always free to make changes to your package. With Blink, itís all about your satisfaction. Letís get started right now:

Contact Information
First Name:
Last Name:
Address:
City:
State:
     
Zip:
Phone:
- - *REQUIRED*
Email:
*REQUIRED*


General Questions
What services are you interested in?
Interactive TV:
Yes
No:
High Speed Internet:
Yes
No:
Digital Phone:
Yes
No:
 
Who are you currently getting these services from?
  
How did you hear about BLINK?
  
Do you qualify for a senior citizen discount (65 or older)?
  


Television
How many TVs do you have?
How many TVs are Flat Screen?
How many channels do you watch?
Do you currently use a DVR?


Internet
What do you use the internet for? Select all that apply:
Searches:
Email:
Shopping:
Gaming
(XBox, PS3-4, Wii, etc..)
Downloading Media
(Movies, Music, Photos, etc..)
Uploading large files
Watching TV programs
Will there be multiple users online at the same time?
Do you currently utilize a router?
If yes, do you:


Telephone
Do you call outside of area code 315 ?
Do you want to keep your
existing phone number?
How often do you use your phone
for long-distance calling?
Comments/Questions:
I agree to the Terms and Conditions