Mark,
You'll need to be within the home coverage area of AT&T Mobility's network to activate an H2O SIM. If you get close enough to reach an AT&T cell tower near the border, it would work.
If you can't physically get to or near the states to activate the SIM yourself, you could mail it to a friend or relative with a GSM phone who's located in the states to do it for you and then mail it back.
Regards,
John L.
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