Internet Service Provider in Misawa, Japan

+81 176 53 5136

Mon - Fri: 9:00 - 17:00

Home Internet Application Form – Misawa –

HeroNet Optical Fiber Internet – Misawa and surrounding area –

12/25/2019

Attention
This application form is for customers in Misawa and surrounding areas only. For Kyotango customers, please go to Kyotango online application. For Shariki customers, please go to Shariki online application.

Please fill out the form below for HeroNet Internet application.

User Information

Last Name *

First Name*

Middle Name

Date of Birth* YYYYMMDD

Gender*

MaleFemaleOther

TEL (Cell) *

E-mail *

Rank *

On base Mail box# *

Squadron/Office name *

Duty phone *

Supervisor Name *

Supervisor Phone *

DEROS/PRD * YYYYMM

Location of Internet

Zip code Leave blank if unknown

Address Leave blank if unknown

House number*

Real estate agency*

Real Estate agency name if it is not listed above.

Moving day *

Moving from on-base to off-base

Yes	Check yes if you are relocating from on-base housing to off-base housing.

Plans

Monthly plan *

Hero L PlanHero S PlanIRH Plan

Hero L Plan – One year contract
Monthly Fee -First Year-	¥8,800/month
Monthly Fee -2nd Year~-	¥6,600/month
Installation Fee	¥0 FREE -Special offer for Hero L Plan-
Sign-up Fee	¥3,300
Cancellation Fee	¥16,500 if cancelled within a year

Hero S Plan – Month-to-Month contract
Monthly Fee	¥8,800/month
Installation Fee	¥6,600 ~ ¥22,000
Sign-up Fee	¥3,300
Cancellation Fee	¥0

IRH Plan (For selected houses only)
Monthly Fee	¥6,600/month
Installation Fee	¥0
Sign-up Fee	¥0
Cancellation Fee	¥0

Installation fee

Installation Fee will be charged if you select Hero S Plan.
We will notify you of the total amount for installation fee when the installation schedule is confirmed.

Payment method *

G.I Bill Pay ServiceCredit card

G.I. Bill Pay Service
Credit cards：Visa／Master Card／American Express／JCB

Uploads

It is not necessary to upload information if the application was done in person at our office.

Please upload your ID(Military ID, Passport, or U.S. Driver’s license).
*You can take picture or scan the documents

Upload ID*
Military ID, Passport,or U.S. Driver’s license

Inquiry

HeroNet Internet Service Policy

I read the HeroNet Internet Service Policy and agree to the terms provided above.

I confirm that the information given in this form is true, complete and accurate.

I confirm that I understand cancellations, no-shows, or extension requests made on the day of the scheduled installation will incur a penalty fee of 6,600 yen.

Yes, I would like to apply for HeroNet Internet service.