Name ____________________________________________________________

Address __________________________________________________________

City ______________________ State _____________ Zip Code _____________

Phone Number _________________________________

Username ( 8 characters maximum ) ________________________

___ I already have internet software
 ___ I need internet software
___ I need assistance with installation

Version of software needed: ___ MAC ___ Windows 95 ___ Windows 98 ___ Windows 2000

Subscription Rates

Monthly Subscription Level ( select one ):

___ $6.95 ( including 15 hours of on-line time )

___ $19.95 ( Unlimited Active Hours )

Setup Fee $19.95

Please include sales tax ( 5.5% )

Make checks payable to:
HSI Business Center
1901 Beaser Ave.
Ashland, WI 54806
715-682-0180