Indian Wells Valley Internet Service Provider
Fax (760) 446-5046
417 Inyokern Road, Ridgecrest, CA 93555

Application Form
Signing up is easy! Print out the form, fill it out, and fax it to us or drop by our office.

Name
Mailing Address
Phone
(Day & Night)
User Id and Password
Your user id is a unique "name" that identifies you to our system when you log in. It must be between 4 and 8 characters and can be any combination of numbers and lower case letters. It will also serve as the prefix to your E-mail address. Your E-mail address would look like this: userid@iwvisp.com Your password, which must also be between 4 and 8 characters long, may include upper and lower case letters and numbers. It should be something you can remember, but not any commonly known information such as your name, address, birth date, age, etc.
User Id
Password

Billing Information for Unlimited Hours** Usage Schedule
Please select one of three billing options: (For other pricing schedules, please contact us.)
Billed monthly by E-mail, $19.95. Pay by cash+, check, or credit card.
Billed monthly by paper invoice mailed via USPS, $20.95. Pay by cash+, check, or credit card
Billed annually by paper invoice or E-mail, $200 per year. Pay by cash+, check, or credit card

Authorization to bill your credit card monthly at $19.95 per month.
Name on Credit Card
Credit Card Number
Expiration Date Initials

I agree to the Terms and Conditions for Internet Accounts as posted and periodically modified by IWVISP.
Signature
Date

*This information is optional but will help us track problems.

**Unlimited Hours is defined as no limit to the accumulated hours for a given month. A limit of the number of hours on at a given time without logging off may be implemented without changing this definition of Unlimited Hours. Unlimited Hours is not meant and does not allow it to be a method of hosting a local server. Please contact us for this pricing information.

+Do not mail cash.

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For questions or comments about our web service contact:
support@iwvisp.com