High-Speed Internet Request Form

Thank you for your interest in the 4GAS.ONLINE Rural America internet program. This form is used to gather basic information so we may qualify you for internet services in your area. 4GAS.ONLINE is an authorized resale partner for several carriers and will attempt to confirm your address for the best service plan available. After submission of your information our representative will contact you promptly. You may also call us at 815.205.3300 after you complete your application so we can expedite processing and handling your order. We are open M-F 830AM-8PM and Sat/Sun 830A-5P or by email to help@4gas.online. Thank you for your interest and welcome to a new way to do internet.

Robert Villanueva
4G Antenna Shop Inc.

* Required to complete application.

Please provide the primary address you intend to use the internet service at. Shipping address if different can be provided in the notes section.

Please provide us your best contact number that we can reach out to you with more information within the next 24-48 hours. We will attempt to contact you and if we are not unsuccessful in contacting you, your application will be placed in a do not disturb status.

Required for business applications.

Please attach proof of your business, such as business license or Federal EIN Application. Contact us at (815)496-0444 for more information regarding this requirement.

Please let us know which team member helped you on the phone so we can assign that person to your application so they can continue to help you.

Adding an outdoor antenna enhances signal reception to your modem by eliminating everyday inside the house inferences caused by other electronics in the home or business: Pricing for an outdoor antenna is as low as $39.99 one time purchase and can make a big difference in service quality.

4GAS uses both USPS and UPS to ship your modem/antenna products to you, If you are just purchasing a MODEM from 4GAS the normal shipping charge is $8 Flat rate and is shipped by USPS (Post Office), if you are purchasing an Antenna Kit along with your modem, Shipping is FLAT Rate at $25 and is sent by UPS. You will receive a tracking number once your package has shipped.

Coverage is not available in all areas. The 4G Antenna Shop Inc. does not guarantee service will work in your area. Your sales consultant will double check your area for coverage and technology in your initial setup call.

By submitting an application for service with the 4G Antenna Shop Inc. you agree to terms set forth on this website. Furthermore you confirm that you are authorized to obtain services from the 4G Antenna Shop Inc. and meet the minimum required guidelines for service with the 4G Antenna Shop Inc.. If you are unsure of the requirements please visit the following links below for more information:

Rate Plans Q&A

Return Information and Conditions of Sale

4G Antenna Shop Inc. Authorized Re-seller Program

Add any special information such as shipping or rate plan instructions.

By submitting this application form you agree that you have reviewed the information provided on this site and are in full understanding of the terms, policies and procedures of the 4G Antenna Shop Inc. and you allow 4GAS Online to continue with the application process on your behalf.

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