First Name
Last Name
Address
City
State
Zip Code
Phone 1
Phone 2*
If you are under the age of 18 you will need to come into our office with a parent or gaurdian to have the sign a hard copy form.
*optional, a second phone number is not required.
Please select the type of subcription that you prefer:
Logins: Your login serves as your connection to the internet. Please give us your main username and a second username, if your wish. You may use letters or numbers or both. All letters must be lower case. No spaces, underscores, or special characters – just small letters and / or numbers. Must be at least 4 characters but no more the 16. To maintain system security, Monkey Worx /Cube will assign you a password for each username.
User Name 1:
@monkeyworx.com
Password 1:
User Name 2:
@monkeyworx.com
Password 2:
Does your PC have a CD-ROM?
Yes
No
Please tell us the type of operating system you are using:
Windows 95/98
Macintosh
Windows ME
Linux
Windows 200
Windows XP
Other
Please make payments out and send to:
Cube Communications, Inc.
722 SE 1 Ave
Ontario, OR. 97914
If you have any questions pertaining to DSL Internet Access, please call us at: 889-7375.
©2003 CUBE Communications and Consulting, Inc. all rights reserved.
