Sign-Up New User Form
Poster's Email Address:
Newuser First Name:
Newuser Last Name:
Company:
Address:
City:
State:
Zip:
Phone:
Available Accounts
Check
Hours/Mo
Web Page
Cost/Mo
Setup Cost
Unlimited Access *
Yes
$15.00
$25.00
Email Only
No
$5.00
$15.00
* One email account included
Software?
Netscape/Dialer Software Needed:
None
Win98
Win95
Win31
Payment Info
The follwing fields are
REQUIRED entries
Credit Card Type:
Visa
MC
Disc
Name on Credit Card
Credit Card No.:
NUMBERS ONLY
Card Expires on:
Example: 01/01/99
New User Account Info
The follwing fields are
REQUIRED entries
Desired UserID:
4 - 8 Characters
Dial-Up Password:
Minimum of 6 Chars
Email Password:
Minimum of 6 Chars
Your account will be active within 24 Hours.
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