City-Guide ISP Signup Page
Account Information
Personal Information
* Required Information
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First I.
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Last Name:
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Address:
Address 2:
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City,
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State
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ZIP:
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AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
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MO
MS
MT
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ND
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NH
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NY
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OK
OR
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SC
SD
TN
TX
UT
VA
VT
WA
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WV
WY
Company:
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Home Phone:
Work Phone:
FAX Number:
Support Information
Computer:
Modem Brand:
Modem Speed:
9600
14,400
28,800
33,600
56k v.90
N/A
64K ISDN
128K ISDN
56k Flex
56k X2
OS Version:
Macintosh
OS/2
Other
Unix
Web TV
Windows 2000
Windows 3.1
Windows 95
Windows 98
Windows Millenium
Windows NT
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Notes:
Copyright 1998 City-Guide Internet Service Provider