Sign up

Sign Up

Fill out this form to register your new Element Wireless Service. We cover a large area from Fisk, Broesely, Poplar Bluff, Harviell and areas in between, using this form does not guarantee service at your residence or place of business all service’s are pending a site survey. After you submit this form we will contact you and schedule a site survey to determine if we can provide you with a stable internet connection at the plan you requested.

Corona virus update: With the steady rise in cases we are watching the situation closely. The last thing we want is to get sick from a customer or to spread the disease to our valued customers. We are enforcing social distancing where possible and encouraging our techs to wear masks while on jobs near the public.

Name*



Phone*



Your Email*



Address*




Select your plan*


Preferred time to contact you*


How did you hear about us?


Comments


Terms of service

By checking this box you agree to our policies listed here


* is a required field