INFOSERVE

New Dial-Up Account Signup Form

To open a new dial-up account with Infoserve please fill in the form below. If you want to open an ADSL account Click HERE

Make sure you enter your email address in this form. Once your account is processed we will contact you on the email address you provided here.

Make sure you have read and agreed to our membership terms and policy statement before you proceed. If you have not read the agreement please review it now SERVICES

Your First and Last Name:

First name

Last name

Your Address:

Street address

Address (cont.)

City

Province

Postal code

Home Phone

Work Phone

FAX

E-mail

Account Information:

Enter your preferred User Name. The User Name must be at least 3 characters and not more than 12 characters. You can use - or _ to separate words. If you choose johndoe as your User Name, your internet email address will be: johndoe@infoserve.net

User Name

Enter your second choice for User Name in case the first choice is not available:

Second Choice

Enter the password you want to use. The password must be at least 6 characters in length but not more than 9. The password cannot be the same as your Username. You can use letters, digits or special characters:

Password

Are you running:

Win95
Win98
WinME
WinXP

Choose one of the following payment options:

VISA
MasterCard
Cheque

If you choose to pay by VISA or MasterCard we will contact you for the credit card information later.
If you choose to pay by cheque you must make quarterly payments for the UNLIMITED class membership and 6 months payment for the SILVER membership. Please send us a cheque with the appropriate amount. Our mailing address is: #205 5679 Imperial Street, Burnaby BC V5J 1G1

Choose type of account you want to open:

UNLIMITED - Unlimited access, $8.95/mth ($10.20 with taxes, or $30.61 for 3 months)
SILVER - 30 hours/month, $8.00/mth ($54.96 with taxes for 6 months)

Enter any comments below:

Street address
Address (cont.)
City
Province
Postal code
Home Phone
Work Phone
FAX
E-mail