Keyway-Cybertime:: Dial-Up Sign Up

DIAL - UP MEMBERSHIP APPLICATION

The fields marked with a * are required. We require a valid method of contacting all customers so that we may confirm an order. If you do not fill all of the required fields, we will be unable to create the account.

First Name:	*
Last Name:	*
Mailing/Billing Address:	*
City:	*
State:	*
Zip:	*
Phone Number:

REQUESTED LOGIN INFORMATION

The User Name and Password must be between 4 and 12 characters. It must also be in lower case letters, or numbers. It CAN NOT be any other symbol or a space. The User Name and Password will also be used as your email login User Name and Password.

User Name:	*
Password:	*

TYPE OF ACCOUNT DESIRED *

Personal Dial-up $19.95 a month
Senior Citizen (65+) $16.95 a month

PRO-RATING OF PRESENT MONTH

On all new accounts it is our policy to pro-rate the first month.

METHOD OF PAYMENT

Enter the name shown on your credit card: *
Credit Card Type:	*
Credit Card Number:	*
Expiration Month/Year:	/ *
CVV/CVC/CID Number:	*

QUESTIONS AND COMMENTS




By submitting this form, you are authorizing Keyway-Cybertime Network Services to charge your credit card.

Furthermore, you affirm that you have read and agreed to all CNS terms of service (TOS), Acceptable Use Policies (AUC), and conditions.

Click here to view TOS, AUP, and conditions.