Installation Form If you are a human and are seeing this field, please leave it blank. Fields marked with an * are required Customer Information First Name * Last Name * Phone * Alternative Phone Email Location Information Address * Unit/Apt City * Stratford St. Marys Postal Code Site Survey Taken From * InsideOutside Weather * ClearRain Technician Name * AP MAC (no colons) * AP Channel * 1 2 3 4 5 6 7 8 9 10 11 CPE Model * CPE MAC (no colons) * Condition * New Used Date * Time * AMPM Test Information Upload Speed * Download Speed * Signal Strength * SNR Test * ***Please attach a line of sight picture. * Install Information Install Date * Install location on property. * Sign Up Type * $199 ResidentialBusiness ClientOther, specify below. Please indicate how the customer paid. * CashCredit Card If the customer paid cash, do they require a receipt to be emailed?? * Yes No Not Applicable Is there any other information you wish to include regarding this customer or installation?