Mobile Internet Services on 9/7/2010 6:15:06 PM


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Sign Up For MOBIS Internet Access

Please fill out the appropriate information, then select the options that you would like to receive pricing and information on.

Fields marked with * are required!

Title:

Mr. Mrs. Ms. Dr.

*First Name:

*Last Name:

*Phone Number:

(xxx-xxx-xxxx)

Home FAX Number:

(xxx-xxx-xxxx)

Business Information if applicable:

Company Name:

Business Telephone:

(xxx-xxx-xxxx)

Business FAX:

(xxx-xxx-xxxx)

Your Address:

*Street Address 1:

Street Address 2:

*City:

*State:

(2 letter abbr.)

*Zip Code:

(5 digits+4 digit extension if available)

I currently have Internet access from another company:

Yes
No

Current E-Mail Address:

Account Information:

Please select your desired account name which will be used as your dial-in account name, email address. If you require a Web Page then this username will also be used for ftp access to our web server. The ftp server has a username limit of 8 characters and must be in lowercase. Some common usernames may already be in use so please enter additional choices.

*First Choice:
*Second Choice:
*Password:

I will be using my Internet account for:

Personal
Business

I wish to pay for my account:

Monthly, credit card
6 month pre-paid, credit card
1 year pre-paid, credit card
6 month pre-paid, check
1 year pre-paid, check

Credit Card Information: IMPORTANT

To submit your credit card information, please call us at (251)433-3418





I found out about MOBIS from: MOBIS Home Page Web ISP directory or index Yellow Pages / Phone Book Mail coupon Newspaper TV MOBIS Customer: I will be using the following modem or terminal adapter: V.90 K56 Flex ISDN 1 B channel (64 Kbps) ISDN 2 B channels (128 Kbps) ADSL Other: If you would like a email copy of your sign up then please fill in your current e-mail address below.

For more information on our services, contact us at

Mobile Internet Services
202 Congress Street
Mobile, AL 36603

support@mobis.com

Information and tech support line is 251-433-3418.

You Are Visitor 980470

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