EnglishSpanish First Name * Last Name * Contact Number * Email Address * Street * City/Town/Village * District *—Please choose an option—CorozalOrange WalkBelizeCayoStann CreekToledo Digi AirNet (Rural Areas where DigiNet is not available)*—Please choose an option—Air Prime - $43.88 MonthlyAir Max - $77.63 Monthly Cell Phone Number Payment MethodOnline PaymentIn Office Payment Please enter below a preferred time of contact. Date—Please choose an option—Monday - FridaySaturday Time—Please choose an option—8:00am - 5:00pm12:00pm - 5:00pm5:00pm - 6:00pm * Indicates a required field Upload ID:(Valid Social Security or Passport)
