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Pre-Qualification Page
In order to provide as accurate response as possible, we need to ask for your personal information. L A Bridge assures all users of this web site, that information provided for the inquiry into or establishment of service is strictly confidential. As a policy of principal and ethics, L A Bridge Internet and DSL has never and will never share, sell, trade, or otherwise abuse any personal data entrusted to our company UNLESS as required by subpoena.

*indicates required fields 
  *First Name:
  *Last Name:
  *Address at install location:
  Apt./Suite/Building:
  *City:
  *State:
  *Zip Code:
  *Call Back # (e.g. 3102283626):
  Phone number to add DSL on:
  *email address:
  *Service Type::
  *Bandwidth:
  *Telco Territory:
  *Term:
  Customer Comments:
  Instant messenger addr.:
  How did you find us?:

Please review the information above for completeness and accuracy. The more complete and accurate the information, the more accurate our reply will be. If you're satisfied the information is correct, please click on the "Submit" button to begin the pre-qualification process.
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