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Cisco 3G Resource Center

Activation/Rebate Request Form for Cisco 3G Devices

To activate your Cisco 3G device on the AT&T, Sprint, or Verizon Wireless networks, and receive your Cisco 3G Product Rebate, please complete this form and hit the “Submit” button at the bottom of this page.

 Note:  Items in bold are required fields.
 

Customer Contact Information:

First Name:  
Last Name:  
Title:  
Company:  
Federal Tax ID:
  Without Dashes (example: 123456789)
Years In Business:
Work Phone:
E-mail:  
Street Address 1:  
Street Address 2:
City:  
State:      Zip:  
Preferred Carrier:
Preferred Carrier Account#:  (if known)
   

Cisco Value Added Reseller Contact Information:

First Name:  
Last Name:  
Title:  
Company:  
Work Phone:
E-mail:  
Street Address 1:  
Street Address 2:
City:  
State:      Zip:  
Cisco Sales Order#:
Distributor:
Distributor Sales Order#:
   
Device Type (e.g. Cisco 3G HWIC):

Please Provide the or ESN/IMEI information here (list one per line):

ESN(s) / IMEI(s):
   

Rebate

Send Rebate To:
   
   

Misc

Notes: