Attachment A: Internet Service Provider Worksheet
Please complete this form prior to your scheduled installation. The easiest way to gather this information is to call your Internet Service Provider and ask them the questions listed below. This call to your Internet Service Provider should only take about 5 minutes.
It is your responsibility to complete this form before your technician arrives.
| QUESTIONS | FIELD | CUSTOMER ENTRY | EXAMPLE | |
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| 1. Is the IP address static or dynamic? | Static IP address |
| 178.182.12.13 |
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| IP Subnet mask |
| 255.255.255.0 |
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| If it is static have the internet Service | ISP Gateway Address |
| 172.134.122.100 |
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Domain Name Server |
| 233.221.213.10 |
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| provider give you any required settings. If |
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| it is dynamic, skip this section. | (DNS) Address |
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| 2. Does the Internet Service Provider | ISP User Name (PPPoE) |
| jdoe123 | |
| service use PPPoE |
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ISP Password (PPPoE) |
| 99btlber | |||
| Protocol over Ethernet)? |
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| If so, have the provider give any required | Service Name (PPPoE) |
| (this field may not | |
| settings. If not, skip this section. |
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| be required) | |
| Note: These settings are typically required only |
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| for DSL Modems. |
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| 3. Does the connection have an |
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| assigned Host Name? | Host Name |
| MY_ISP | |
| If so, enter the host name here. |
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| 4. Does the connection have an |
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| assigned Domain Name? | Domain Name |
| FRONTIER | |
| If so, enter the Domain name here. |
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| 5. Is the connection bound to a MAC |
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| address? |
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| If so, enter the MAC address here. | MAC Address |
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| Note: These settings are typically required only |
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| for cable modems. |
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| Page 5 of 6 |
v 2.6 |
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