FILL-OUT-FORM for NEW Subscriber
to www.MrINTER.NET

I will subscribe for a UNLIMITED TIME  PPP-account with MrINTER.NET and receive all programs I need to enjoy the WWW NET:

$ 19.50/mo. USERS ACCOUNT, NO sign-up or Registration Fees!
$ 50.00/mo. BUSINESS ACOUNT, Set-up starts $ 50
$ 75.00/mo. COMPANY ACCOUNT, Set-up starts $ 75
$100.00/mo.CORPORATION ACOUNT, Set-up starts $ 150
$ 50 Set-up for a standerized Home-page, with my Name & E-mail
$ 9.95/mo. for additional E-mail box
Call me for more INFO about my own DOMAIN NAME and cost

Information about myself:
: E-mail Address, if applicable
http://: URL, if applicable
: Name & Title/Position
: Company Name
: Address
: City
: State/Province
: Zip/Postal Code
: Country
. : Phone & Fax Numbers

This is my NEW USER Name: (8 letter lower case)
This is my NEW PASSWORD: (6 upper case)

I will pay in the form of:
A M E XV I S A Master CardC H E C K CASH, send with Envelope CALL me for my CARD number
Credit Card #: Expiration Date:

Please call me back!

Short INFO about my Computer System:
I have/use a Macintosh IBM
I like/use the Browser NETSCAPE SUPER MOSAIC
I have/use a modem with 9.600KB/sec 14,400 28,800