REGISTRATION FORM FOR A NEW CLIENT
Before the submission of this form, please be sure that all fields are filled correctly.
PROFILE INFORMATION
First Name
Last Name
Company
Address
City/Province
Telephone
Postal Code
ACCOUNT INFORMATION
User Name
!
Use only letters (a-z), numbers (0-9), and
no spaces
.
Password
!
Must be
at least eight (8) characters long
, may contain numbers (0-9) and
lowercase letters
(a-z),
but no spaces
. Make sure it is difficult for others to guess.
Re-enter
Password
Secret question
Enter a question only you know the answer to and that has nothing to do with your password.
If you forget your password, we'll verify your identity by asking you this question.
Answer to secret question
POP ACCOUNT PASSWORD INFORMATION
(optional)
Pop Account 1
Pop Account 2
Pop Account 3
SERVICES INFORMATION
Dial Up
Access 30 hrs. monthly
Unlimited Access 33.6/56.6 Kbps
LAN Access Unlimited 33.6/56.6 Kbps
Leased Line Connection
28.8 Kbps
33.6 Kbps
64 Kbps
Before the submission of this form, please be sure that all fields are filled correctly.
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Copyright © 2000 Geo Enterprise Ltd. All rights reserved.
Last updated on 10/29/2000
