Appgen ISP Module - Update User



This is the form where Harry selects the service he wants and the method of payment.


For our demo lets sign up for the Dial-Up Analog Internet Service.

Fill in the form and then click on "New User".

EI010100 

My ISP Company 


AIM Customer Maint.-Add

*Master UserID

harry

Customer Code

8235

Name

Harry J. Smith

Notice Date

5/12/2000

ADDR2

123 Way Out West Ave.

Status

City State ZIP

Last Chance, CO 81435

Reason

Day Phone

Nite Phone

Last Invoice

6521

Contract

Term

Notice Type

Tax Code

Taxable

Service

Password

Quantity

Discount

Contact

Start Date

CPU Type

Zone

Group

Domain

Expiration

E-Mail Addr


C R E D I T    C A R D / B A N K    D R A F T    I N F O R M A T I O N


Payment Method

Card Type

Acct Num

Exp Date

AVS

AVS ZIP