Computer Services/CPW-Budget Phone

"In Business since 1996"

Sign Up Form for Dial-up Internet

This form will email us with your information to sign up for our Dial-up Internet service. After receiving your information one of our employees will contact you to enable your access and e-mail privileges and to confirm that you can connect.

Internet access information we need

Sign up for:

Time

Price each

200hrs

$10.00

Unlimited

$14.95

Total:

Name:

Address:

Phone:

E-mail:

Method of Payment

This credit card information may be sent to an unsecured site and may be visible to others.

User Name:

Password: