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Power Net Internet Services

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Please fill out each section as completly as possible for fastest service.


YOUR INFORMATION

Your Full Name:
Your Current Email address:
Contact Name:	( if other than yourself )
Your Title:
Your Company Name:
Your Street address:
Your City, State, Zip:
Your Daytime Phone No.:
Your Fax No.:
Your Evening Phone No.:

SERVICES DESIRED

I wish to be placed on the list for "PERSONAL" wireless ACCESS @ 2mb/sec in the Midland Odessa area.

Which operating system do you use? ( For Tech Support use )

What is your Modem's speed? ( To help us provide you with the best dial-up number )

What would you like for your email address ? ( 8 characters or less, lowercase )

Please provide 3 choices:
Choice #1: @powr.net
Choice #2: @powr.net
Choice #3: @powr.net

Password Desired:

PAYMENT METHODS

My Payment Method:
Credit Card Number Exp.Date
Name exactly as it appears on your credit card

If Auto Check Draft: Bank Name & Address:

Please enter ALL the numbers FROM the bottom of your check.
If you selected the "Auto Check Draft Option, You must provide a voided check to our billing dept. We will contact you.

If you selected "Other",... payment arrangements must be approved by PowerNet before account activation. We will contact you with information ASAP.

Thank you! Please press this button to send us your information.

Accounts are activated within 2- 4 hours. For more detailed information, Please call 915- 570- 4300

PowerNet provides direct multihomed Internet connectivity. PowerNet supports dialup modem speeds up to 56Kbps ( K56Flex and v.90 Only ). PowerNet supports ISDN (digital) dialup adapters at 64Kbps or 128Kbps speeds. All prices are subject to change without notice. All fees are subject to applicable state and local taxes. All accounts are subject to the PowerNet Terms and Conditions statement. On-Site Installation is available at an additional service fee.