Customer Service/Cancellation of Services Form

Please fill in the form below completely. Incomplete forms can not be processed. Please keep in mind that if you are requesting that your service be discontinued, you must submit the request in writing prior to the 20th of the month in order to avoid billing for the next month. There are no exceptions to this rule. You can fill out this form, you can fax it to 757-222-1002 or you can mail it via the US Mail to Eagles Nest, Ltd., PO Box 510, Virginia Beach, VA 23451. Phone requests will not be accepted under any circumstances. This is for your protection as well as ours. This way we have it in writing, and you do too, and nobody can play a prank on you.

Customer Name:
Day Phone:
Evening Phone:
Fax:
Current email address:
Login name:
Password:
Date you want service discontinued:
Please enter your reason for discontinuing our service, as we would like to know if you are having problems, going on vacation or what other reasons you may have.

We appreciate your input as to the reason you are disconnecting your service. We strive very hard to maintain the highest quality Internet service possible, and we value your opinions and input greatly. Thank you for giving us your input in the blank to the left.
Please process my request.
Name: