Area Code:		Phone Number:
Area Code:		Work Phone:

	Account Type:	Monthly Internet Access - $20.00
		Semi-Annual Internet Access - $100.00
		Annually - $180.00
		Additional Email Box - $1.00/Month
		Additional 5MB Webspace - $5.00/Month

Internet accounts include 1 email box and 5 megabytes of personal webspace.

How did you hear about CityScape? (Check all that apply):
Radio advertisement
Newspaper advertisement
Phone Book
Online advertisement
From a CityScape employee
From a CityScape customer
From a friend
I used my favorite search engine

Operating System:
Windows 98
Windows 95
Windows 3.1
Other

Payment Option:
Visa/Mastercard
Invoice

Thank you for choosing CityScape Communications for your Internet needs. A representative will contact you regarding your new account as soon as possible.