& St. Louis Works - Providing local internet service to Bond, Clinton, Madison, Marion, St. Clair, Washington, St. Louis City & St. Louis counties!!!!!!!!!!!		 Customer Service
Headquarters
(618) 526-8301
1-(800)-765-7772
Fax (618) 526-1115
 
NEW CUSTOMER INFORMATION FORM: Mail this form to TechDoctors, PO Box 388, St. Rose, IL 62230


Name: _____________________________________________________________________
Company Name: _____________________________________________________________
Billing Address: ______________________________________________________________
City, State, Zip: ______________________________________________________________
Home Phone: _____________________ Work: __________________ Fax: ______________
Desired Login Name: __  __  __  __  __  __  __  __
Your Login Name can be up to 12 lowercase characters containing no punctuation or symbols.
Password: __  __  __  __  __  __  __  __
Your Password can be up to 12 characters containing lower case letters or numbers only.

 
Specify which Dial In Access you would like to use: __ Breese 
__ Greenville 		 __ Highland 
__ Metro-East		 __ Centralia 
__ St. Louis		 __ Vandalia 
__ Nashville
 
ACCOUNT TYPES
1 Month 
6 Months 
  
1 Year 
Registration Fee
__ Basic Plan
__
 *$18.50 
__
 $111.00 
__
 $222.00 
$25
__ Surfer's Choice Special
__
 $180.00
$25
__ Small Business Plan
__
 $22.95
__
 $153.90
__
 $290.70
$30
 
 _________Additional E-mail Account(s):   Additional E-mail address(es) to go with your regular access account.
$2.50 per month.        Login Name __ __ __ __ __ __ __ __  Password __ __ __ __ __ __ __ __
 
St. Louis Works Hosting Plans-Give us a call for personalized hosting plans starting at $22.95/month
Account TypeService Length1 month6 months1 yearRegistration fee
__ Corporate Business Plan (1 Year Plan)__$49.95__$299.70__$599.40$49.95
(2 Year Plan)__$39.95__$239.70__$479.40$49.95
__ Enterprise Business Plan (1 Year Plan)__$59.95__$359.70__$719.40$59.95
(2 Year Plan)__$49.95__$299.70__$599.40$59.95
__ e-Commerce Plan (1 Year Plan)__$149.95__$899.70__$1799.40$400.00
Billing Information
If you choose to pay monthly, payments must be made on or before the 7th of each month.  If payment is not received by the 17th, a $5.00 Service fee will be applied and you will be sent a statement.  If payment still is not received by the 30th, the account will be disconnected until payment is received.  We do not send out a billing reminder until payment is past due.  It is the customers responsibility to notify us if cancellation of service is requested.  We are not responsible for charges associated with the local telephone companies concerning Internet accounts.  *Registration fee is non-refundable and set up or installation of any browser is not included with the registration fee.  Please makes checks payable to PapaDocs sent to: P.O. Box 388, St. Rose, IL 62230.

__ Charge my credit card/monthly                     __ I will send a check by the 7th of each month
__ Charge my credit card every 6 months          __ Enclosed is a check for 6 months of service
__ Charge my credit card/yearly                        __ Enclosed is a check for 1 year of service
 
 
__ Visa Card Number _____________________________________  Exp. Date ________
__ MC  Card Holder ______________________________________  
__ Discover  Signature _________________________________________  
  Signature: ____________________________________ Date: _____________

* Set up or installation of any browser is not included with the registration fee.