Company
Name:_________________________________________
Zip Code/PO
Box________________________________________
Best Phone
Number:_____________________________________
Type of Computer: Windows 98 Win2000 WinNT Win3.1 Macintosh
Best Times to call back and set up:_________________________
Desired E:mail
Address:__________________________________
Extra E:mail
addresses:___________________________________
Website or special
needs:_________________________________
Password:______________________________________________
Account type:
Standard Unlimted Access and 20 MB Website $19.95 _____ Annual $199.50 _____
Economy Unlimited Access $14.95 _____ Annual $149.50 _____
Lifeline 30 Hours Access $9.95 _____ Annual $99.50
_____
| BBV Use Only | |
| Atechno Dialup _____________
new-account 752-0552
BBV ns1 ___________________ adduser BBV Virtusertable ____________ pico/etc/mail/virtusertable |
Comments/Account,
Referred by
bbv _________ bbv __________ |