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Action Internet Access Application

*Indicates Required Information

User Info:

*Street Address:
*Zip Code:
*Phone Number:
Business Home
Phone Number:
Fax         Work

Payment Info:


*Payment Via:

Credit Card     OR     Sending Check

If Credit Card fill Out Info Below:
Name As Appears on Card:
Credit Card #: Must be a Visa or Mastercard.
Expiration Date: Example: 12/01
*Type of Account:
Dial-Up ISDN 64K ISDN 128K
3 Month $59.85 $75.00 $150.00
6 Month $119.70 $140.00 $280.00
1 Year $219.45 $260.00  $520.00
Between the 11th and 22nd of the month you will be charged for only half of the current month.  After the 22nd your payment will go for the next month.

Account Info:

Your account and Email will be  identified by your User Name. Your User Name cannot contain a space or special characters and must be no longer than 8 characters. Please list two (2) possible User Names in the event the first one is already assigned. Use only lowercase letters. (Ex. jdoe)

*First Request for  Username:      8 Char limit
*Second Request:      8 Char limit

Your Password must be at least 6 characters long, but no longer then 10 characters.  One of the characters in your password must be a number.
Allowing another individual to use your Password is strictly forbidden as such actions pose security and legal problems and may result in cancellation of your Account.

*Password (6 to 10 chars with at least one #)
*ReType Password:

With your account you are allowed to have a second e-mail account.  If you would like to setup a second e-mail account at this time please fill in the information below.  If not you can sign up this second e-mail account at any time using the link on Action's home page.

Second E-Mail Account Desired: Yes  No

If yes fill out info below
First Request for Second 
E-Mail Username:
     8 Char limit
Second Request for 
Second E-Mail Username:
     8 Char limit
Second E-Mail 
(6 to 10 chars with at least one #)
Re-type Second E-Mail  Password:

Your Computer Info:

*Operating System:
*Modem Speed: Kbps


Action provides software for you computer.   This software is sent out after we have received this application and payment.   The software Action sends out is: Microsoft Internet Explorer 5.01.  This software is multiple builds newer then the version included in Windows98 SE.  The software runs on a 486dx66 or higher processor, with a minimum of 16MB of Ram and Windows 95 or higher.  If you do not wish to receive this software please uncheck the box below.

I Require Software:




Terms of Agreement:

Buy agreeing to this application you acknowledge that, as a member of the System, you understand that changes are made occasionally to the Terms and Conditions document as posted electronically on the System. Any questions related to the Terms and Conditions should be directed to a system administrator. As a subscriber, you agree that should you ever be unwilling to comply with any provision in the current Terms and Conditions document that you will immediately cease using the System and contact Action to request that your login account be closed. Any violation of the Terms and Conditions may result in the loss of System access privileges and/or legal action against the individual(s). All accounts include 60 days free Technical Support - $20 per incident thereafter.

Furthermore, you agree to the following cancellation procedure when/if you decide to terminate this agreement. This procedure does not apply if your account is terminated by Action for any reason.

1) No refund of setup fee(s)
2) Full refund of account fee if unable to connect within 1st 10 days.
3) Refund on 6 & 12 month contracts = 50% of remaining contract fees (based on calendar months)
4) All requests for Cancellation/Refund must be received in writing (email or USPS) with full account information (username, password, etc.)
5) All requests for Cancellation/Refund must be received on or before the 1st day of the month of Cancellation.


By clicking below you agree to the above terms and to the charges stated above for service. If you do not agree click here.


If you would like a current E-Mail account notified when your account is setup please fill out the space below:


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