CompuSol - Internet Sign Up





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Saturday, July 19th 2008	I N T E R N E T \| S I G N - U P \| E C C O

Internet Access Sign-Up Form

At this point, you can do one of the following:

Fill in the on-line sign-up form below

Call 1-843-525-9225 to register by phone

Return to our Home Page

Please fill in to sign-up for local Internet Access:

Local Internet Access Request for:
Service Type (choose one):
Name (First & Last, required)
Billing Address:
Box or Street: (required!)
City: State: Zip: Country:
Phone:	Fax:
Setup Information:
Login Name: (Please enter all lower case 8 letters or less - i.e. John Smith = jsmith) 1st Choice: 2nd Choice: 2nd Email:
Password: (Please enter 6-8 characters all lower case, one character not a letter) Password choice: (Good examples: cat4me ur4tun8 Bad: scott1 abc123)
Submitter/Payee Address (if different from above):
Name (First & Last, required!):
Street (Credit Card Billing Address):
City: State: Zip: Country:
Phone:	Fax:
Submitter E-Mail:
Web site URL: (if available!)	Request Link:
Credit Card Information: (Express Order call 843-525-9225 9am-8pm EST)
Visa Mastercard Discover Amex Check by Fax or Phone
Name on Card:
Card Number:
Exp. Date: (MMYY)

Please submit the Order or print and fax this page to 843-525-1377. Otherwise include Check, Money Order, Credit Card Info or Cash
and mail to CompuSol · P.O.Box 927 · Beaufort · SC 29901 · USA
Internet Access Schedule
There is a one-time signup fee of $14.95. We will contact you with your access number and login codes as soon as your payment is cleared. You will receive statements depending on your term of service and billing type.

I N T E R N E T | S I G N - U P | E C C O