YES! Please establish a personal dial-up and email account for me as follows, per my specifications below.

I understand that I will be billed monthly at the rate of $8.95 per month, and acknowledge that I have read and agree to the Terms of Service and Privacy Policy.

First Name:

Mailing Address:

City:

Daytime Phone:

Fax #:

Your family dial-up service includes an email account with an account name @okiemail.net. List your first and second choices for account names below.

  Contact me with my account information via: Email    Fax    Telephone