Dialup Internet Services Agreement

Date___________________

Customer Name: __________________________________________

Customer Address__________________________________________

________________________________________________________

Telephone Number:________________________________________

Desired username:____________________________

Desired Password:____________________________

Please select one type of service:

1. Monthly charge of $14.95 plus tax charged to Credit/Debit card, Check, Cashier Check or Money Order every month___

2. Three months charge of $41.85 plus tax charged to Credit/Debit card, Check, Cashier Check or Money Order every three months___

3. Six months charge of $77.70 plus tax charged to Credit/Debit card, Check, Cashier Check or Money Order every six months___

4. Yearly charge of $120.00 plus tax charged to Credit/Debit card, Check, Cashier Check or Money Order every year___

GGE will automatically withdraw from your Credit/Debit card every first day of every month, three, six months or yearly depending of your choice.

GGE will take checks as long as the check is in our office by the first of each month. Service will be automatically disconnected by our system

by the third day of the month if check or payment has not been received. Returned check will be charge with a $30.00 fee.

Cancellation service can be started by either party with in one month in advance. Refunds will be the total payment miinus days in use, plus 15% service charge.

_________________________________________________________

Customer signature

By signing, customer agree with above conditions