You can use this form to sign up for internet access immediately... First Name: Last Name: E-Mail Address: Choose a Service Plan: Select a service $18.95 per month $96.65 for 6 months $185.30 for 1 year Are you renewing your account? Yes No Street Adress: City: State, Zipcode: Home Phone: Work Phone: What type computer? PC Mac Operating System? Win3.x Win95 Mac-OS Browser Software? Netscape Internet Explorer Please enter your Requested USERID Password (lowercase, min 6 characters) Password again for verification Personal security code (i.e. mothers maiden name) Select a payment method I'll call 315-446-2898 w/credit info Check Visa Mastercard Discover Please enter your Credit Card Number I authorize Traknet to Charge my Credit Card Monthly 6 Months 12 Months Please enter your Expiration Date Please enter the name as it appears on credit card    * Monthly Service I understand my credit card will be charged $18.95 per month for service after the initial period until I cancel with 30 days notice in writing to Traknet, 2780 Erie Blvd East, Syracuse, NY 13224. ** 6 or 12 month service I understand I will be billed following the initial period to my address on file. I understand I will be billed in advance for the subsequent months after the initial period. I must notify Traknet in writing with 30 days notice to cancel my service or I will be responsible for any remaining balances due. E-mail comments, suggestions to: webmaster@traknet.com © 2000 Traknet Internet Services.   All Rights Reserved.