Internet Sign-up Form

*Last Name:
*First Name:
*Address:
*City:
*State:
*Zip:
*Phone #:
*User Name: @hometc.com
*Password:

Affiliate Name:

Monthly Fee
*Dial up Location or Dial in number
Customer will use 		(i.e. Sebring 304-0005)
E-mail 2:
Password 2:
E-Mail 3:
Password 3:
E-mail 4:
Password 4:
* Required Field

Dial Up Numbers:  

Avon Park Dialup:
Sebring Dialup:

 434-0005
304-0005
Technical Support: 10am-7pm CST M-F
Ottawa Local: 785-242-2031
All Areas: 877-242-2071
Technical Support: tech@hometc.com
Primary DNS: 65.16.28.101
Secondary DNS: 65.16.28.104
POP3 Email Server: postoffice.hometc.com
SMTP Server: postoffice.hometc.com
   
Note About Email:
 Your e-mail address is what you chose for your "User Name" on the left of this form, followed by @hometc.com. For example if you chose "computer" as your "User Name", your e-mail address would then be:
computer@hometc.com
 
Note About Username:
In order for you to successfully login to our server and get on the Internet you must use your full e-mail address as your username.
As in the example above: computer@hometc.com
Signature:______________________________________
I agree to abide by the terms and conditions set forth concerning the proper use of this service.