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1Dial Web Accelerator Sign-up Form

In order to sign up for the 1Dial Web Accelerator, Please submit the following information.  Payment for this service is required before service begins.  Customers will have 7 days upon installation and use of our service to receive a full refund if not completely satisfied with our 1Dial Web Accelerator service.

 

CUSTOMER INFORMATION:

NAME: 

ADDRESS:

                    

CITY: 

STATE: 

ZIP CODE: 

PHONE NUMBER: 

CURRENT EMAIL ADDRESS: 

 

Select Your 1Dial Web Accelerator Package:

Monthly  ($4.00)

3 Month Package ($10.95)  

6 Month Package ($19.95)  

 12 Month Package ($29.95)  

 

Operating System:

 

Payment Information:

If Paying by Credit Card: 

Card #:    Expiration Date:  (mm/yy)

CVC/CVV/CID Code (From Back of Card):    What's This?

Comments:

 

 

 

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