New User Registration

Computerese Information Network (cin.net) welcomes you to the Information Super Highway. Our service requires the completion of this form.You may fill in the following form on-line or you may download the signup form and fax to us after you complete it with the necessary information. You must be at least 18 years of age to sign up for Internet service. If you have questions regarding this from, please call 847-310-1188 or other local number in your area.

Note: Your name, address, and phone number must match your credit card billing address for us to charge your credit card. If they do not match, we can not charge your credit card and open your account!

Full Legal Name:
Company Name (if applicable):
Address:
City:
State:
Zip:
Home Phone:
Work Phone:		Extension:
Driver's License:
State Issued:
Birthdate:
System showing you'r login from:
You'r login from IP Address:

Please TYPE IN the following:

Username:		Password (case sensitive):

**The "username" is part of your email address. You may select your preferred login name in the first came first served condition. If you select "john," then your email address will be john@cin.net. The username may be up to 12 characters,and minimum of 5 characters. It can be a mix of letter and number as well as "-" and "_". However, the first character must be a letter. USERNAME IS ALWAYS IN LOWER CASE. The "password" is what your need to get into your email and Internet. This must be secure and not be given to anyone. Do not use a dictionary word or a name , from any langauge, as your password. A good password is a mix of characters and numbers (i.e. 17Gkr# of *3gKDF) Remember, it is case sensitive. The minimum length of password must be 6 characters

Payment Type:

** If you select payment by check, your account will not be activated until your payment is received. Click here for the address to send your payment.
** If you select to pay by credit card, please sign this credit card authorization form and fax or mail to Cin.net within 5 days. Your account will be herein automatically charged for renewal when your current term expires. You need to contact billing@cin.net if you want to change the payment method.
***Please note, your new account would be disabled if this authorization form is not received within 5 days.

Access Type: Click here for details

NOTE: **There is a one time $15.00 setup fee on all Access One and 56k Modem accounts, and there is $35.00 one time setup fee for all ISDN accounts.
**If you signup from the area we have promotion, please put the rate advertised in the note below.

Computer Type and OS: WIN95/WIN98 NT WIN2000 XP UNIX / LINUX MAC WebTV

By clicking on the "Submit" button, you agree to follow all Cin.Net User Policies as stated in the User Policies documentation, and be bounded to the payment terms above.

Other Notes