Internet access order form

Sign me up!

Check the services you want and return this form with your payment to TIES at the address below.

____ DSL connection, $239 (includes nonrefundable $20 setup fee; carrier fees are extra and must be coordinated with TIES)
____ On-site DSL installation and setup, $70 per hour

____ Premium Dial-up Internet access, $165 (includes nonrefundable $15 setup fee)

____ Basic Dial-up Internet access, $114 (includes nonrefundable $15 setup fee)

____ Additional e-mail address, $15 each

____ Web page storage, $25

____________________________________________________________________________________________________
First name                                        Middle initial                                  Last name

____________________________________________________________________________________________________
Address

____________________________________________________________________________________________________
City                                                                                       State                                   Zip code

____________________________________________________________________
Area code             Phone number

Choose your e-mail user name. The name must start with a letter and contain at least four and no more than eight alphanumeric characters (lower-case letters only). Indicate your choices, or let TIES assign a name based on your last name. Please print clearly.

1. ________________________________    2. ____________________________________

3. ________________________________    Let TIES assign a name __________________

How did you hear about TIES Internet access?

TIES web site ____   Brochure ____    Colleague/Friend/Family member ____    Poster  ____
Ad in:  Minnesota Educator  ____  MASA Leaders Forum ____  
           MASSP Newsletter ____   PTSA Voice ____ 
Other (please specify): ___________________________________________

PAYMENT

Attach a check payable to TIES for the annual rate plus the setup fee, along with the fees for any additional options. Send the check to:

TIES Internet Services, New Accounts
1667 Snelling Ave. N.
St. Paul, MN  55108-2131

Or call 651-999-6250 to pay with a credit card.

TIES, a consortium of 38 Minnesota school districts, has been connecting education and technology for 39 years.