Internet Connection - Affordable Internet Connection & Web Design Services

User Information:
NOTE: Prompts in bold are required to be filled out.
Your present Email address:
First name:
Middle name, initial:
Last name:
Street address:
City:
State:
Zip:
Work (daytime) phone:
Home phone:
Date of birth (mm/dd/yy):
We can FAX your new user information to you if you like.
Place a checkmark here if you wish that we FAX your new user information to you.
FAX number:
Please give us a secret word. This word will be used by you to positively identify yourself to us if the need should arise. We might need to identify you if you have forgotten your password, or you have other security related problems. May we suggest you use a word that will be easy to remember, such as mother's maiden name, or the name of a past pet. This field may be up to 15 characters long, and may contain any valid ASCII character.
Secret word:
Username Information:
When choosing a username for your Logon, please observe the following guidelines: Usernames can be up to eight characters long. By convention, you may use only lower case letters. You may use any ASCII character, as long as the first character is a letter. Your username is also what you are known by for sending and receiving Email. Your username can be whatever you choose, but it is typically based on some form of your real name. By using some form of your real name, it will be easier for others to recognize, and identify you. As an example, John Doe could have a username of johndoe. John Doe's Email address would then be johndoe@cottagesoft.com.
Please enter a second choice in case the name you have chosen is invalid, or already in use by someone else on the system.
Username first choice:
Username second choice:
Password Information:
Please select a password. The same rules apply here as for usernames. In order to maintain security on the system, we ask that you use at least 6 characters in your password. We do not recommend that you use common words. A combination of letters and numbers works very well.
Password:
Account type selection:
What type of account would you like? For a description of the different accounts, please check out our list of available services if you are unsure which one would be best for you.

Payment Options:
We provide a variety of payment options to meet the needs of our users. Remember, if you selected a credit card option above, you must use a credit card here!
Which method of payment will you be using?
If you selected a credit card billing method, we will contact you for credit card information. Please use our secure web server to send sensitive data such as credit card information.
If you selected billing above, which billing cycle would you like?
Remember, advance payment is required for each period.
Software and other information:
We have diskettes with free software, and information sheets available for many types of computers and operating systems. Please select the most appropriate item from the following list.
Please send me the following:

How did you learn about The Internet Connection?
If you have been recommended to the Internet Connection by a current customer, what is that customer's Name, or Email address?
Comments and Additional Information:

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User Information:

Username Information:

Account type selection:

Payment Options:

Software and other information: