Personal Web Space Signup Form

To have your web space created, complete the form below and click the Submit button.
All items with a red * are required.

 

Account Information:
Name:		*
Address:		*
City:		*
State:		*
Zipcode:		*
Email Address:		*
Dialup Username: (If Applicable)
Phone Number:		*
Web Space Information:
Domain Name Guidelines	Customer chooses the first "word" of the URL. Personal URL limited to availability. (First come, first served.) Customer's chosen "word" may include one word, multiple words or a phrase w/o spaces or punctuation. Length of "word" should be limited to no more than 15 to 20 characters. The "word" must not include profanity, be sexually suggestive or racially insensitive. The final decision on the usability of your requested "word" is solely up to KTIS
Examples	http://john.members.ktis.net http://johndoe.members.ktis.net http://jdoe.members.ktis.net http://johnisgreat.members.ktis.net
Requested Names: (List In Order Of Preference)
http://		.members.ktis.net *
http://		.members.ktis.net *
http://		.members.ktis.net *
http://		.members.ktis.net
http://		.members.ktis.net
Password:		* (6 to 10 Characters Recommended)
Frontpage Extensions:		(Check this box if you are using Microsoft Frontpage)
Commercial Use of Personal Space:		($7.50 /month)
I have read, and understand the KTIS Terms of Use. Furthermore, I understand that if I post objectionable material in my personal web space, KTIS will disable my personal web space as soon as such content is discovered.		* (Terms of Use Policy)