| Personal Information |
| Name: |
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| Address: |
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| City: |
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| State: |
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| ZIP Code: |
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| Daytime Phone
Number: |
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| Evening Phone
Number: |
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| Your Current E-mail
Address (if any): |
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Account Information |
User ID: Your username has to be 3 to 15 characters, and can only be in
letters, numbers, dots and dashes. See
Examples
of User ID's.
This username will also be part of your
e-mail address.
We ask for two choices
in case your first is already in use. In the rare case that both of
your choices are in use, we will let you know when we
call. |
| 1st Choice for
UserID: |
Write this down!! |
| 2nd Choice for
UserID: |
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Password: Your password is the way that you protect
your account from use by other people. It should be 6-10 characters
in length, and contain a mixture of upper and lower-case characters
and/or numbers.
Examples: I8aBuG, Ou8aBUg2. The two
examples given are not good passwords though because anyone can see
them now, so they are no longer "secret". You will be asked below to
enter your password twice so it can be verified.
|
| Password:
|
Write this down, too!! |
| Password:
(Again) |
|
Payment Information |
| ACC-NET
offers different payment options for you to choose from. |
| Please make your
check payable to:
|
Anderson Computer Consulting, Inc.
161 Jamesway
Marion OH 43302 |
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Money
Orders and Cashier's Checks get processed immediately.
Personal checks will be processed when they clear the bank.
Don't forget your Paypal payment will be
processed right away. Please select your billing
option: |
|
Choose 6 months and
get one (1) month FREE.
Choose 12 months and get |
Optional Information |
| These next few questions
are optional so you don't have to answer them, but we sure would
appreciate it if you did. |
How did you
here about ACC-NET?
|
Did a friend
refer you? If so, what is their E-Mail address?
They will
get a FREE month for telling you about us.
|
|
You are now
ready to submit your signup request. Please review all the
information that you have entered to ensure that it is accurate. When you have done that, use the submit button below to submit your
request.
Submitting this request
implies full agreement to ACC-NET Terms and
Conditions.
By submitting this form
you agree to hold Anderson Computer Consulting, Inc. harmless for
any and all possibly conceivable issues. We try our best, but
sometimes issues arise. When they do arise, we promise to deal
with them expediently. Thank you. |
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