TropicNet On-line Individual Subscription Form

Personal information:

Full Name of Account Holder:


Company/Employer:


Mailing Address:



City/State/ZIP:


Day/Evening phone numbers:

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System information:

E-mail address used presently:


Type of operating system used to connect: Windows 3.1x Macintosh Windows 95 OS/2 Warp Unix DOS - text only Other

I have read the on-line instructions regarding connecting to TropicNetwith my type of system.
Software installation and configuration will be performed by:
myself
technicianassistance requested

Desired TropicNet login account name (up to 8 lowercase characters):
first choice second choice

Desired TropicNet password (between 6 and 8 alphanumericcharacters):
must contain both letters and numbers

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Payment information:

We only accept Credit Cards or yearly prepayment by check for new subscribers

Select a method of payment: Credit card (call to supply number) Check (yearly only)

TropicNet charges a one-time $15.00 individual account setup fee, due with your first payment.

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Special information:

The home page included with this account will be used primarily for:
personal
business

Comments:

Commercial customers, please contact TropicNet Inc. at 305.531.1995 for business rates.

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Submit your completed on-line subscriptionform:

If the information entered above is correct, press,otherwise the form.

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Please allow 1 to 2 days for processing and feedback after submittingyour on-line request.
We will call you after your account is opened. Incomplete applicationswill not be processed.