Tribal Address Sign Up

Applicant First Name

Applicant Last Name

Service Address Information

Service Address

City

State

ZIP

Applicant Date of Birth

(Please enter date format as yyyy-mm-dd)

Applicant FSST Tribal ID

Applicant State Issued ID

Current Email

Primary Phone

Secondary Number

Do you have a secondary applicant?

Yes

No

(Spouse, Significant other, Roommate etc.)

Secondary Application First Name

Secondary Application Last Name

Secondary Application Email Address

Secondary Applicant Date of Birth

(Please enter date format as yyyy-mm-dd)

Secondary Applicant FSST Tribal ID

Secondary Applicant State Issued ID

Authorized Contacts

Please Note: The only person(s) authorized to make changes to service(s) on this account is/are the applicant(s) listed above. if you wish for another party to make changes on your behalf (example: spouse, POA, relative, caregiver), please indicate your wishes below. Any charges as a result of changes to this account will be the responsibility of the subscriber to which the account belongs. No minors will be allowed to make changes regardless of subscriber request.

Authorized Contact #1 Name (First, Last)

Authorized Contact Mailing Address

Authorized Contact Phone

Authorized Contact #2 Name (First, Last)

Authorized Contact Mailing Address

Authorized Contact Phone

CPNI ACCOUNT PASSWORD: To Protect the privacy of your account, the FCC has implemented rules, which require you to provide a secure password when accessing information on your account. You will be required to provide this information whenever you call our office to discuss your account. Your password may be at least 4, but not more than 10 characters (numbers and/or letters).

CPNI Password

Broadband Internet Service

The Fiber Hub Solution from Valley FiberCom is your local answer to the challenges of wireless connections in
homes, farms, offices, and more.
Valley FiberCom’s Fiber Hub includes FREE guaranteed Wi-Fi throughout your home.
We install, connect, and maintain your home Wi-Fi, so you don’t have to.

Internet Speed

Gigabit
$149.99
monthly
Unlimited Devices
NO DATA CAPS
Fiberhub Required
FREE Guaranteed Wi-Fi
Select

Fiber Hub - $6.99

Fiber HUB $6.99

Total Service Assurance Plan - $2.99/month

Yes, I would like the Total Service Assurance Plan

Would you like to utilize an email account from Valley FiberCom?

YES, I wish to utilize an email account from Valley FiberCom

I DO NOT wish to utilize an email account from Valley FiberCom

If Yes, Email Username@valleyfibercom.net

Must be between 4 and 13 letters or numbers.

If Yes, Email Password

The password must be between 8 and 13 letters & numbers Upper and lower-case. Password may not be the same as the username.

If using a Valley FiberCom Email Address, the above listed email username will be used as the Broadband Username.
If NOT using a Valley FiberCom Email Address, please indicate a Broadband Username below.

Broadband Username:

Wi-Fi Password - The WiFi Password Makes Your Gigacenter WiFI Connections More Secure.

The password must be between 8 and 13 letters & numbers Upper and lower-case. Password may not be the same as the username.

Please list any customer owned buried facilities, such as sprinkler systems, underground dog fences, geo-thermal, etc or other special instructions as indicated below. Reasonable efforts will be made to minimize disturbance to property.

Other Services from Valley Fibercom

Please contact me regarding Landline Telephone Services from Valley FiberCom.

Please contact me regarding Streaming/TV Services from Valley FiberCom.

Please Note: Landline Telephone Services and Streaming/TV Services monthly fees ARE NOT covered by the NTIA Grant.

Service Address Information

Authorized Contacts

Broadband Internet Service

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