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PERSONAL ACCOUNT APPLICATION
Fax to 773-477-2990
Mail to:Ripco Communications,Inc. 3163 N. Clybourn, Chicago, IL 60618

Ripco Communications Inc. is a registered corporation in the state 
of Illinois, providing commercial and personal Internet access 
services. Ripco provides dial-up services on an "untimed" basis. 
This means NO SET TIME LIMITS, NO MAXIMUM HOURS PER MONTH.  
Individual online sessions may be terminated due to inactivity.  
This is done as a security measure only.  Completing and signing this 
form indicates that you are eighteen (18) years of age or older and 
have read, accepted and agreed to Ripco's Acceptable Use Policy 
(available on our website. If you would like a hard copy of this 
document mailed to you, please contact our offices at 773-528-5020.  
Usage of Ripco accounts in violation of this policy may result in 
immediate termination of the account.  Termination of accounts for 
this reason is not subject to refund.  We reserve the right to cancel 
or refuse service to anyone for any reason.  Accounts are fully 
refundable for two weeks after activation. Refunds after two week 
period are handled on a case-by-case basis.


1.  Circle the type of service you are requesting and the payment 
plan you prefer: (no set up fees!) 

Service type	mo.	qtr.	6 mo.	yr.
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POPMail		$5	$15	$30	$60
Unix Shell	$15	$35	$70	$140
Dynamic IP	$20	$50	$100	$200
Static IP	$50	$150	$250	$500
ISDN-1 (64K)	$50	$150	$300	$600
ISDN-2 (128K)	$90	$270	$540	$1080


2.  Account Information (this information is kept confidential and 
is used to verify identity only.)

Full Name	
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Street Address	
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Additional Address	
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City, ST, Zip	
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Daytime Phone	
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Evening Phone	
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Date of Birth or Code Word*
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* used if you call in to have your password reset.

3.  Account Name: (The full account name will show on electronic mail 
sent from your account.  If you leave this field blank, we will use 
the "Full Name" above.)  

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4.  Preferred Login Name Choices: (8 letters or numbers used to log 
into the Ripco network and which will become your e-mail address.)
a. 
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b. 
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c.
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We will send the selected login name and password to the address you 
indicated above.  Please contact us if you do not receive this 
information within 10 days.  If your account isn’t activated within 10 
days, it will expire.   It can be reactivated upon written verification 
of your account information.

Signature
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Date
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Payment Method (Circle One)

Check/Money Order Enclosed       Visa/MasterCard     Pay Pal