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Eskimo North DSL Broadband Pre-Qualification

We do not spam, sell, or trade your information!
Information will be used to establish your account and communicate setup instructions.

We will contact you at the number you leave to finalize the order (obtain credit card info, etc.).
Your application will be discarded if it can not be verified within two weeks.

Your shell account and E-mail will be created and DSL service ordered only after verification and payment made.


First and Last Name:
Street Address (DSL location):
City, State and ZipCode:

Please use the format XXX-XXX-XXXX.
We can not process an order without a complete and correctly formatted telephone number.


Voice Telephone Number:
DSL Circuit Number:
Your current email address:

Please select a login name to use on Eskimo North hosts (email, ftp, Usenet). Your login:
  • May contain only the following:
    • Lower case alphabetic characters [a-z]
    • Numeric characters [0-9]
    • Dash [-]
  • Must NOT START with a dash.
  • Must contain at least one non-numeric character.
  • Must not exceed eight characters.
  • Is your e-mail address here at Eskimo North.
Login:

Please select a temporary password to use on Eskimo North. Your password:
  • Should be different from your login.
  • Needs to be at least five characters long.
  • May contain any printable character. UPPER case is distinct from lower case.
  • Can be changed at a later time by you at the shell prompt.
Password:
 
Add a 56k dialup connection (roaming access) for $4/month?
 
How did you hear about Eskimo North?


(restart the application)


(send the application)

Eskimo North, Inc.
P.O. Box 55816
Shoreline, WA 98155-0816
USA

Voice Phone: (206) 812-0051
Toll Free: 1-800-246-6874

Fax: (206) 812-0054

EMail: support@eskimo.com



Content:
Copyright 2007
© Eskimo North