| Contact
Details |
| First
Name |
|
| Last
Name |
|
| Street |
|
| City |
|
| State
|
|
| |
|
| Home
Phone |
|
| Work
Phone |
|
| Current E-mail Address |
|
| Payment: |
|
| Requested User ID |
|
(This
is part of your e-mail address. Please specify more than
one preferences.)
(Your Login Name must consist of 3 to 8 letters or digits.) |
| Password: |
|
| (Please
use 6 to 8 characters. Please print, but we will use all
lower case register.) |
| |
Please
subscribe me to the 3net’s Flat Rate Dial-up
Account.
I have read and accept the
terms and conditions for the service.
I understand these terms and conditions are available
on request and posted on the World Wide Web page of
3net. Please bill me quarterly starting from this
quarter.
|
|
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|
