By completing the form below, you agree to comply with all FTC-I.Net Terms and Conditions and accept full financial responsibility for services rendered by FTC-I.Net. Your application will not be processed unless all information is complete. Within 72 hours, your username and password will be sent to you via US Postal Service at the mailing address entered below. If you need more information about FTC-I.Net Click Here or call your local FTC Customer Service Department.

* = Required fields

Contact Info.
E-mail
Day Time Phone
Last Name
Middle Name
First Name*
Business Name (If applicable)
Phone*
SSN
Business/Home Address
Street Address*
PO Box
City*
State*
Zip Code*
Service Info.
You must select one option.
Type of Internet Service	DSL Business - $44.95/month DSL Residential - $34.95/month DSL Employee FTC Provided Router NONE Customer Provided Router NONE Unlimited Dial-Up Monthly Plan $19.50 Unlimited Dial-Up Annual Plan $198.00 ($36 savings) Basic Dial-Up Plan $11.50 for 20 hours ($1.00 each additional hour) Other (Frame Relay, ISDN) Call 1-800-671-0669 for details
Username
You must supply three usernames and security code. 4-12 characters Subject to Availability
Username #1	1st Choice
Username #2	2nd Choice
Username #3	3rd Choice
Security Code	(i.e. Mother's maiden name, pet's name, etc.)
Notes Questions Comments