Application for Premium Mobile HotSpot – for Misawa Area Customers Please fill out the form below for HeroNet Premium Mobile HotSpot plan application. User Information Last Name * First Name* Middle Name Date of Birth* YYYYMMDD Gender* MaleFemale TEL (Cell) * E-mail * Mail Box# * Squadron/Office name * Duty phone * DEROS/PRD * YYYYMM House numberIf you live off base Employment Status Active dutyDOD employeeContractorOther Monthly plan 【Premium】Mobile HotSpot 500GB【Premium】Mobile HotSpot 300GB【Premium】Mobile HotSpot 200GB【Premium】Mobile HotSpot 100GB Premium Mobile HotSpot Plan 500GB LTE ¥8,800/month 300GB LTE ¥7,700/month 200GB LTE ¥6,600/month 100GB LTE ¥5,500/month Sign-up Fee ¥3,300 Device (Purchase plan) ¥17,900 First months fee will be prorated, but cancelling month WILL NOT be prorated. Tax included in prices. Inquiry Pick-up at HeroNet office Once you submit the form, HeroNet staff will contact you for contract details and scheduling pick-up date. Please note that there may be a waiting list depending on the availability of devices. HeroNet Mobile HotSpot Service Policy HeroNet SIM Card 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. Δ