[ I n f o C h a n n e l ] Online Subscription

Personal Plan Online Subscription Form

Please complete all sections of the form below.
Sections not applicable should be marked with an asterisk ( * ).

Contact Information

Type of Plan Desired
First Name
Middle Initial
Last Name
Mailing Address
Telephone # (home)
Telephone # (work)
Fax # (home)
Fax # (work)
E-mail Address

User Information

Which of the following does your computer use?
Are you a new Internet User?
• Current ISP
Have you ever been an InfoChannel subscriber?

If "Yes", please state the following:

What type of InfoChannel Personal Plan did you have?

Was this plan primarily for business or personal use?

Why are you no longer an InfoChannel subscriber?
*

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Personal Plan Online Subscription Form

Contact Information

Type of Plan Desired

First Name

Middle Initial

Last Name

Mailing Address

Telephone # (home)

Telephone # (work)

Fax # (home)

Fax # (work)

E-mail Address

User Information