Signup for Conxxus Dial-Up Service

Please fill out the following form to signup for Conxxus's dial-up Internet service.

An Conxxus representative will contact you regarding finalizing your new Internet service.  We look forward to providing you and your family with local Internet service.   If you have any questions, feel free to contact us at sales@conxxus.com or at (877) 455-4266.  Thanks.

Name       

Address    

City             

Zip Code     

Phone Number

SS# or DL#

Windows Program

Username (4 - 12 characters)

Password (4 - 12 characters)

Internet Package    

Billing Method  

Current E-mail Address   

Best time to contact you  

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