Mohawk Networks Television Activation Form
Residential Services
Please complete this form to sign up for Television Service with Mohawk Networks.
Service Location Information (where you want to have Internet service)
Phone Number Type:
Type of Home:
If you chose "Other", please describe your home below:
Do you rent or own this property?
** IMPORTANT: If you rent your home, we will send you a form to be completed and signed by your landlord BEFORE we can schedule your installation. **
 
Billing Information (where you want the bill to be mailed)
If you choose to become a customer, will your Billing Address the same as your Service Address you typed above?
 
If you selected NO, please give your billing address below:
 
 
Pricing
  • 80-Channel Television-ONLY Service (with a variety of premium channels included): $64.99 per month for UP TO 2 televisions
  • Additional televisions are $6.99 per month per television.
  • Discounts available for senior citizens and bundled services.
    Please call for details: (518) 358-2105 {Monday - Friday 8am - 5 pm}
Number of televisions you would like on your account:
 
 

Acceptance of Terms & Conditions

"I give Mohawk Networks permission to call or email me to schedule the installation of television services at my residence."

Your Electronic Signature 
** Your electronic signature is recognized as legally valid and binding, just as your signature is on paper, as per the Electronic Signatures in Global and International Commerce act (ESGICA) of 2000. **
 
Today's Date
** ALL PAYMENTS MUST BE IN U.S. DOLLARS (USD) ONLY. **
 
*** To sign up for OPTIONAL Auto Pay Services, you will need to request an additional form
by calling or emailing our office. See your confirmation email for details. ***