Name* First Last Customer Number*Phone*Email* Enter Email Confirm Email Current Address* Street Address Address Line 2 City ZIP Code Date to Disconnect* Date Format: MM slash DD slash YYYY New Service Address* Street Address Address Line 2 City ZIP Code Date to Activate Service* Date Format: MM slash DD slash YYYY Last 4 Digits of SSN*If you are an auto credit/debit card draft customer, your draft information will NOT transfer. You will need to re-enroll with your new account information. Contact customer service at 251-626-2628 for your new account information.VerificationTo protect our site and your information against spam bots and to let us know that you are a real human, we have added an extra security measure of verification. Please enter the numbers in the picture above.EmailThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.