Step 1) Enter your Personal Information:
Name:
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Address Line 1:
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Address Line 2:
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City:
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State:
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Zip Code:
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Day Phone #:
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Evening Phone #:
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I will use this
account for: |
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Other:___________________________ |
Step 2) Enter Your User Information:
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How did you
hear about Blacksburg.Net?__________________
___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ ___________________________________ |
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__ Windows 95 | __ WebTV |
__ Brand:
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__ DOS | __ Unix |
__ Model:
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__ Macintosh | __ Other: _____________ |
__ Speed:
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Choosing your Username and Password | ||||||||||||||||||||||||
Choosing a USERNAME: a USERNAME (Sometimes called a PID or Login Name) is your email name and login name. It can be from 1 to 8 characters long and can contain lowercase & uppercase letters and numbers. Your email address will be USERNAME@Blacksburg.Net . For example the USERNAME JoeUser would have the email address JoeUser@Blacksburg.Net | Choosing a PASSWORD: Your PASSWORD may be 6 to 16 characters and at least one character should be a number or symbol. Case is significant in a password. Your password should not be easily guessable. You should not use choices like your date of birth, your spouses name, your dog’s name, or variations of the above. | |||||||||||||||||||||||
Username Choice 1: | Enter Desired Password Below: | |||||||||||||||||||||||
Username Choice 2: |
Step 3) Choose The Service Plan You Wish To Use:
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Annual Cost |
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Plan 1 | Unlimited Access* | Dial Up | Advance Payment Plan** |
$16.95
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$20.00
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$203.40
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Plan 2 | Unlimited Access* | Dial Up | Credit Card – Billed Monthly |
$17.95
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$20.00
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$215.40
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Plan 3 | Unlimited Access* | Dial Up | Cash or Check -- Quarterly prepaid | $17.95 | $20.00 | $239.40 | ||||||
Plan 4 | Unlimited Access* | Dial Up | Cash or Check – Monthly prepaid |
$19.95
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$20.00
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$239.40
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Choose Your Plan | |||||||||||
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Plan 1: I wish to SAVE MONEY via the Advance Payment Plan** | |||||||||||
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Plan 2: I wish to save money by paying monthly by credit card | |||||||||||
Credit Card #: |
Expiration Date:
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_____/_____ | ||||||||||
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Plan 3: I don’t care about saving money, just bill me monthly | |||||||||||
Setup Fee:
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$20.00
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* Blacksburg.Net
provides Unlimited Interactive Access. See Terms and Conditions
for details.
** By paying in one year in advance you get access for ONLY 16.95 PER MONTH (Form Revision #: 010623) |
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Prorated Monthly Fee:
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$_____.___
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Monthly Fee:
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$_____.___
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Total:
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$_____.___
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Signature: _____________________________________________ Date: ________________________
Return to Blacksburg.net Home Page | Questions or comments, please send mail to: webmaster@blacksburg.net |