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| <html> | |
| <head> | |
| <title>Customer Data Print Page</title> | |
| <meta name="Microsoft Theme" content="none"><meta name="Microsoft Border" content="t"></head> | |
| <body background="../../../Images/Backgrounds/BsuNetBackground.gif"><!--msnavigation--><table border="0" cellpadding="0" cellspacing="0" width="100%"><tr><td><font face="arial, helvetica" mstheme> | |
| <p align="center"><img src="../../../Images/Logos/BsuNetlogo.gif" WIDTH="310" HEIGHT="86"></p> | |
| </font mstheme></td></tr><!--msnavigation--></table><!--msnavigation--><table border="0" cellpadding="0" cellspacing="0" width="100%"><tr><!--msnavigation--><td valign="top"> | |
| <p> </p> | |
| <table border="1" width="90%" height="162"> | |
| <tr> | |
| <td width="45%" height="28">Last Name</td> | |
| <td width="39%" colspan="2" height="28">First Name</td> | |
| <td width="16%" height="28">Initial</td> | |
| </tr> | |
| <tr> | |
| <td width="45%" height="26">Street Address</td> | |
| <td width="28%" height="26">City</td> | |
| <td width="11%" height="26">State</td> | |
| <td width="16%" height="26">Zip</td> | |
| </tr> | |
| <tr> | |
| <td width="100%" colspan="4" height="27">Mailing Address (If Different):</td> | |
| </tr> | |
| <tr> | |
| <td width="45%" height="27">Phone (Hm)</td> | |
| <td width="39%" colspan="2" height="27">Phone (Wk)</td> | |
| <td width="16%" height="27">Fax</td> | |
| </tr> | |
| <tr> | |
| <td width="100%" colspan="4" height="24">Existing E-mail, if any:</td> | |
| </tr> | |
| </table> | |
| <p><font face="Bookman Old Style" size="2"><b>PLEASE INDICATE YOUR CURRENT SOFTWARE | |
| PLATFORM ON THE MACHINE YOU WILL <br> | |
| USE TO DIAL UP BSU.NET. </b></font></p> | |
| <p><font face="Bookman Old Style" size="2"> | |
| ________ WINDOWS 95 ________ WINDOWS 98 | |
| ________ WINDOWS | |
| NT </font></p> | |
| <p><font face="Bookman Old Style" size="2"><strong>PLEASE INDICATE YOUR COMPUTER | |
| MANUFACTURER AND MODEM TYPE AND SPEED:</strong></font></p> | |
| <p><font face="Bookman Old Style" size="2">COMPUTER | |
| MANUFACTURER:__________________________________</font></p> | |
| <p><font face="Bookman Old Style" size="2">MODEM | |
| TYPE/SPEED:__________________________________________</font></p> | |
| <p><big><font face="Bookman Old Style">===========================================================</font></big></p> | |
| <p><font face="Bookman Old Style" size="2"><b>CLEARLY PRINT YOUR PREFERRED <u>LOGIN NAME</u> | |
| AND <u>PASSWORD</u>. </b>(<u>LOGIN NAMES</u> MUST <br> | |
| BE 4-8 CHARACTERS OF YOUR CHOICE. FOR EXAMPLE: JSMITH MIGHT BE A LOGIN NAME FOR <br> | |
| JIM SMITH. <u>PASSWORDS</u> MUST BE 6-8 CHARACTERS OF YOUR CHOICE. HOWEVER, THEY <br> | |
| <strong>MUST</strong> CONTAIN AT LEAST ONE <strong>NUMERIC</strong> DIGIT. PASSWORD | |
| EXAMPLE: JUPITER2. </font></p> | |
| <p><font face="Bookman Old Style" size="3">LOGIN NAME: ______________________________ | |
| </font><font face="Bookman Old Style" size="2">(4-8 Characters, example: | |
| jsmith)</font></p> | |
| <p><font face="Bookman Old Style" size="3">PASSWORD: ________________________________ </font><font face="Bookman Old Style" size="2">(6-8 Alpha/Numeric, example: jupiter2)</font></p> | |
| <p><big><font face="Bookman Old Style">============================================================</font></big></p> | |
| <p><font size="2">PLEASE DELIVER YOUR COMPLETED APPLICATION FORM, TOGETHER WITH THE SIGNED | |
| TERMS OF <br> | |
| SERVICE TO THE BUSINESS BUILDING, ROOM 308, DEPARTMENT OF CIS/POM IN THE COLLEGE OF <br> | |
| BUSINESS.<strong> </font><font size="2" color="#000000" face="Arial">The cost for each | |
| semester (Fall and Spring) is $30.00. The cost for summer is $10.00. <br> | |
| Therefore, the cost for year round internet is a total of $70.00. Before | |
| processing your application <br> | |
| you must pay the amount due for that current semester.</font></strong><font size="2"><b> </b>ALL | |
| ACCOUNTS WILL BE MADE ACTIVE BY <br> | |
| 6:30 P.M. THE FOLLOWING BUSINESS DAY. BSU.NET RESERVES THE RIGHT TO REFUSE SERVICE | |
| TO <br> | |
| ANYONE AT ITS SOLE DISCRETION. </font></p> | |
| <p align="left"><small><small><small><strong><!--webbot bot="Timestamp" s-type="EDITED" s-format="%m/%d/%y %I:%M:%S %p" startspan -->10/07/99 10:55:27 AM<!--webbot bot="Timestamp" endspan i-checksum="28482" --></strong></small></small></small> | |
| <!--msnavigation--></td></tr><!--msnavigation--></table></body> | |
| </html> |