SWD Residential Internet Service Request

875-E US Highway 491/PO Box 4011, Yatahey, NM 87375
Tel: (877) 722-3393        Fax: (505) 905-6001

We Speak Navajo. Diné bizaad nihił bééhózin.

RESIDENTIAL INTERNET SERVICE ORDER

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NAME
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MAILING ADDRESS
Street*
City/Suburb
State*
Zip/Post Code*
Country*
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SERVICE ADDRESS
Enter if different from mailing address
Street
City/Suburb
State
Country
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TELEPHONE NUMBER
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E-mail Address
Please enter a valid email
Date of Birth
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Please enter a valid date
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SSN
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Employer Name and Address
Name of Joint Applicant (if applicable)
Joint Applicant's Date of Birth
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Joint Applicant's SSN
Joint Applicant's Telephone Number
Please Include the Name and Phone Number of a Reference 
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Authorized Contacts
Please list the names and phone numbers of any individual(s) authorized to make changes on your account, or to call in and discuss your telephone bill, account services or balance due.
Please list the names and phone numbers of any individual(s) authorized to make changes on your account, or to call in and discuss your telephone bill, account services or balance due.
How did you hear about us?
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Higher speeds may be available in your area. Installation charges may apply. Not all speeds are available in all locations. High-speed internet subject to availability of facilities and capacity. Terms and Conditions apply.



Need a Lifeline? See if you qualify for Lifeline discounts by visiting the Lifeline Support website, or call our office at (877) 722-3393 to discuss your options.

RESIDENTIAL INTERNET PLANS
Residential Internet Plans
Prices shown are monthly rates. Select from the following 1-year or 2-year plans. Installation fees are waived on 2-year plans.
25 M 1-YR SUBSCRIPTION
$69.95 
50 M 1-YR SUBSCRIPTION
$89.95 
25 M 2-YR SUBSCRIPTION
$54.95 
50 M 2-YR SUBSCRIPTION
$64.95 
Prices shown are monthly rates. Select from the following 1-year or 2-year plans. Installation fees are waived on 2-year plans.

Monthly Modem Fee
$5.00
RESIDENTIAL VoIP PHONE SERVICE


Residential VoIP Service
(VOIP or Voice Over Internet Protocol is phone service that is delivered via the internet.)
Unlimited nationwide long distance with other features
Residential VoIP
$18.99 
(VOIP or Voice Over Internet Protocol is phone service that is delivered via the internet.)
Unlimited nationwide long distance with other features

Interested in traditional phone service? 
If you select Yes, a customer service representative will reach out to you to discuss your options
Yes
No
Please choose an answer
If you select Yes, a customer service representative will reach out to you to discuss your options

*Prices shown do not include taxes, fees and other charges  required by law.


By signing, I acknowledge I have read, understand, and agree to pay all one-time and monthly recurring fees applicable to the Service Plan(s) which I selected above, and I have read, understand and agree to all Terms and Conditions and not participate in Robocalling.

Do you agree to the Terms and Conditions?
Yes
No


Sign here
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SUBMIT

Sacred Wind is an equal opportunity provider and employer.

In accordance with Federal Civil Rights law and U.S. Department of Agriculture (USDA) Civil Rights regulations and policies, the USDA, its agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior credible activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint filing deadlines vary by program or incident. 

Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the responsible Agency or USDA's TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.

To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at How to File a Program Discrimination Complaint and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: program.intake@usda.gov.

USDA is an equal opportunity provider, employer, and lender.