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High-Speed Wireless Information Request Form

To request information regarding a free site-survey, please complete the required fields below.


A RipNET Wireless representative will contact you within 24 hours of form submission.


Please forward this page to any friends or neighbours who may find wireless service convenient for them.


For further information please contact RipNET: 1-888-509-6677 or 1-613-342-3946 or email wireless@ripnet.com

Customer Information

* First Name * Last Name
* City/Town Address
(911 Addressing)
* Postal Code Company Name
* Home Phone ** Daytime Phone
Fax * Email
Notes - Use the area below for any additional information you wish to provide.
* required
** required. This phone number is where you can be reached during the day.