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44 N. 4th St., Zanesville, Oh. 43701   740-453-5953, 1-800-281-4625
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Dialup Form Print Sheet

Click Here to print & fill out the Dialup Request Form:

Your Full Name: _________________________________
Phone Number: _________________________________
Physical Address: _________________________________
City, State & Zip: _________________________________
Dialup & Email User Name: ________________________________________________ @icsisp.com
Dialup & Email Password: _________________________________ (Minimum of 5 Characters)
Today's Date: _________________________________
Billing/Dialup Start Date: _________________________________ (NOTE: OFFICE USE ONLY)
Computer Type: _________________________________ (Example: Desktop or Laptop)
Operating System: _________________________________ (Example: Windows 98, ME or XP)
Billing Method: _________________________________ (Example: EMAIL, CASH, CHECK, VISA, MASTER or DISCOVER)
Billing EMAIL Address: ____________________________________________________________
Terms & Service Agreement: YES or NO (Please mark Yes or No - This is the agreement for the Terms Below)
Installation Type: Self Install (Free with Instructions) or ICSISP Install ($64/Hr - 1 PC Only)*
*Note: For install of multiply PC's requires extra hardware - Wired or Wireless Router/WAP (Wireless Access Point). Call for further details.
Do you need additional Email Accounts: YES or NO (Please mark Yes or No)
How many additional Email Accounts: _________________________________ (Please write 4 if you only want the 4 extra free accounts, if you need more write down how many so we know the monthly charge per email account, which is $1 each account per month).
    DIALUP TERMS AND CONDITIONS

    Standard Access:
  • There are no hourly charges for Standard Access Accounts under 200 hours usage per month. (.25 per Hour charge applies over 200 hours). You get fast and reliable analog connections at 28K, 33.6K, or 56K. Other digital connections at 64K and 128K are available in most areas. ICSISP reserves the right to refuse access (during peak usage times) to users who exceed the 200 hour per month standard.

    • Live Support Specialists:
  • ICSISP will give you live support for IE and Netscape browser configurations and provide assistance with your email program and Internet connection. Our help desk is open from 8:30 am to 5:00 pm Monday through Friday, and 9:00 am to 3:00 pm Saturday.

    • Late Payment:
  • If an account is not paid within 10 days of invoice date then a late fee of $5.00 will be assessed. If an account is not paid within 14 days from the invoice date it will be put on-hold. If the account is not paid within 21 days from the invoice date the account will be terminated and advance payment will be applied to final month. In the event a Subscriber issues a bad check or if a credit card is denied, the Subscriber agrees to pay ICSISP a service charge of $20.00.

    • Payment Methods:
  • Credit Card - Customer calls and gives one of the following card types (Visa, MasterCard, Discover and Bank Debit Cards) to be entered on their account.

    • Check, Cash or Money Order - Customer sends or drops off check or cash to the following address below:

    ICSISP
    44 North 4th Street
    Zanseville, OH 43701
Applicable to Dynamic Products
Laptop users and some desktop users may need to purchase a Modem.

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webmaster@icsisp.com