*Name

First name Last name

Phone Number

If you have any contact number

*Email

*Re-enter Email

*State and City

*State: —以下から選択してください—AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingWashington,D.C.Puerto RicoVirgin Islands of the United States

*City:

Expected period of use
for long-term users

—以下から選択してください—2-6 months6mon-1yr1yr-2yrs2yrs-3yrsMore than 3yrs

At the time of application, we will check whether your credit card is valid.
Please enter your credit card information exactly on the card.
If you enter incorrect or invalid credit card information, we will not activate.

*Name on the Card

*Card Type

VISAMASTERAMEXDiscoveryJCB

*Credit Card Number

Please enter without spaces or hyphens.

*Expire Date (Month/Year)

—以下から選択してください—010203040506070809101112 / 20—以下から選択してください—21222324252627282930

*CVV

Address (registered on the credit card)

*Address 1 (Street address)

Address 2 (Apartment, Suite, Unit, Building, Floor, etc.,)

*City

*State

—以下から選択してください—AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingWashington,D.C.Puerto RicoVirgin Islands of the United States

*Zip code

Activation Information

*Desired Activation Date

1. Today(within 24 hours)

Year: —以下から選択してください—2021202220232024202520262027202820292030
Month/Date: —以下から選択してください—010203040506070809101112 / —以下から選択してください—01020304050607080910111213141516171819202122232425262728293031

Please submit the request by 7:00p.m./ET if you wish to activate on the same day.
All requests received after 7:00p.m./ET will be activated the next business day.
If you picked a specific date, it will be activated on the desired date. Please note that the time cannot be specified.
We will send you a confirmation Email with the service information (phone number, how to use service, etc.) after it is activated.

*SIM Card Number #1
(Do not enter ActFast Code)

89014102

Please enter the 12 digits following "89014102" below the barcode on the back of the SIM card.
If the SIM card number is incorrect, it cannot be activated.

*SIM Card Number #2
(Do not enter ActFast Code)

89014102

Please enter the 12 digits following "89014102" below the barcode on the back of the SIM card.
If the SIM card number is incorrect, it cannot be activated.

*Amazon Order ID
(3 digits-7 digits-7 digits)

--

Please enter the Amazon Order ID.
If the order ID is incorrect, it cannot be activated.
The order ID can be found under “Returns & Orders” on your Amazon account.

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Important

Please read the terms and condition before using our H2O Wireless service.
By using our service, you are agreeing to bound by the Terms and Conditions.
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