Internet Access Check Order Form

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INTERNET Level 105. . . . . . . . . . . . . . . . . . . . . $5.00 /mth
Internet E-Mail.
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INTERNET Level 110 . . . . . . . . . . . . . . . . . . . . $10.00 /mth
15 Hours per month max.
60 cents per hour over 15 hours.
Auto Renewal Credit Card only.
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INTERNET Level 115 . . . . . . . . . . . . . . . . . . . . $15.00 /mth
Our Flat Rate Account includes:
Modem Dial up Access up to 56K Baud or 64K ISDN.
Personal Web pages up to 10 Meg, EZ-HTML Editor.
10 E-Mail accounts@heartoftn.net & No Setup Fees.
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INTERNET Level 120 . . . . . . . . . . . . . . . . . . . . $25.00 /mth
Includes all features of Internet Level 115 Plus
Multi-connection or Bonded access up to 128K ISDN.
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INTERNET Level 130 . . . . . . . . . . . . . . . . . . . . $30.00 /mth
Business Account, includes Levels 115 and 140.
That's 10 + 10 E-Mails and 10 + 10 Meg of Web space.
Our 20 / 20 Special includes it all, Call for more info.
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INTERNET Level 140 . . . . . . . . . . . . . . . . . . . . $15.00 /mth
Business Web Pages up to 10 Meg, CGI & SSI,
FTP Access and 10 E-Mail accounts@your.domain.
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INTERNET Level 150. . . . . . . . . . . . . . . . . . . . $100.00 /mth
FULL TIME Connection up to 56K baud or 64K ISDN.
Static IP Address for Gateway, WWW, or FTP Server.
Startup Fee $100.
(Remote Services and Dial up Devices allowed on Level 150 Only)
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Advertising on our Home Page:
Rotating Banner Ads are available for $10 per month.
Rotating Banner Ads linked to a web pages, $5 per month.
Static Banner Ads are available for $40 per month.
(Advertising on WEB Pages Allowed on Level 130 & 140 Only)
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Method of Payment:
Advance payment required. Expiration date set on first connection.
Accounts completely removed on expiration date.
American Express, MasterCard, VISA, Checks or Money Order.
Tennessee Sales Tax of 8.75% applies to all Internet services.

 

Please enter your information below.
All fields are required to submit your Virtual Check.

 

 First  Name Last Name
 Phone Number:
 Address:
 City State  Zip

 

Internet Dial Up Access

      Quantity
     

*User Name (Login Name)
@heartoftn.net
(Login Name is the same as your Primary E-Mail Address)

*Password you wish to use.

(Password and Login Name must be in lowercase / No Caps)

How did you here about us?

Enter additional E-Mail addresses / passwords and other instructions here.

 

<<< By Checking this Box, as owner and authorized signor of the checking account below, you hereby authorize us to duplicate the enclosed check information in bank draft form for this one transaction only. No other bank drafts may be created on your behalf without your direct authorization.

Name as listed on account

Amount of Check

Bank Name

Bank Address

Bank City

Bank State

Bank Zip

Bank Phone (include area code)

Using the diagram on the right as an example, enter the information that appears at
the bottom of your check.
Routing Number

Account Number

Your Check Number

By submitting this form you authorize us to draft your account, specified above, for the "Total" amount shown on this form in return for the products selected above. You acknowledge that you are the owner or authorized signer on the account information entered in this form. If paying by check, your order will be processed through your local bank as a normal check by the Checknique program, and your account will never be accessed electronically. After you have entered the information, there is no need to send the check to us. Simply write the ordering information in your checkbook, just as if you had sent it in. Please remember to remove the check from your checkbook and void the check. Keep that check for your records.