PCI Broadband Rebate Offer


How It Works:

 This offer is for purchasers of the Actiontec(r) GT701 DSL Modem purchased from Qwest between 12/1/2007 and 5/31/08. Limit one rebate per name, address or household.
 *Please follow these directions:

* 1) *Print out this page*
*  2) Complete the required information in the form below
*  3) Enclose a copy of your Qwest phone bill (proof of purchase) showing the $59.99 Actiontec(r) GT701 DSL Modem fee. Shipping and handling fees will not be rebated.
*  4) Mail to: *PCI Broadband, 5770 Flintridge Dr, Suite 100, Colorado Springs, CO 80918 before 5/31/08.

*  Name: _________________________________________________
*  Mailing Address: ________________________________________
*  Address (second line): ____________________________________
*  City: ____________________ State: _________ Zip: ___________
*  Phone: __________________________
*  Email: __________________________ 
* PCI Userid_______________________

* 5) Please allow 4-6 weeks from the time we receive your form for your rebate to arrive.
* 6) You must be a PCI Broadband customer in good standing to qualify for this special offer.


Please check one of the following:

Send Refund Check____________     or    Credit my Account_____________