Q-Express Sign Up
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Rates And Plans 		Q-Express

Sign Up For This Great New Service!
Now Available in Hampton Roads, Richmond, Hopewell, Chester, Front Royal, and Culpepper.

Now also available in Knoxville, Tennessee



Features Include:

  • 2 E-Mail Addresses*
  • Thousands of Newsgroups
  • 5 Megs of Space for your Personal Web Site
  • Several Programs and Rates to Choose From
  • Credit Union Monthly/Quarterly Statement via E-Mail
    (for members of participating credit unions)
  • Home Banking (for members of participating credit unions)
  • Digital Modems and Phone Lines X2/56K/V-90 Protocol

*Available for customers purchasing Standard Plan or ISDN.


Please fill out this form entirely to sign up. Click the send button when done.



Personal Information
Enter your First Name
Last Name
Street Address
City                       State  Zip
    
Home Phone Number 
Work Phone Number


Q-Express Information
Desired E-Mail address 
 - Default E-Mail is e-mailname@q-express.net or choose another.
Make up a Password
 - Keep this private. Must be at least 6 characters(numbers and letters),
   (Max of 20).
Re-Type Password
 - Confirm your password. 
Second E-Mail address 
 - We now offer a second E-mail address at no extra charge.
Make up a Password
 - Can be the same password or make a new one.
Re-Type Password
 - Confirm your password. 
Home Banking Password
 - We recommend having a separate password for Home Banking.
Re-Type Password
 - Confirm your Home Banking password. 
Modem Speed 
 - If you're not sure, select "Other".
Operating System 
 - If you're running something besides Windows select "Other".



Payment Method 

   Members of Participating Credit Unions 

Members of Credit Unions contracted with Q-Express.Net can have their monthly Internet Access Fee deducted automatically from either their checking or savings account. Please indicate the Q-Express.Net Program you would like, the Credit Union you are a member of, your account number, and which account you want it taken from. Q-Express.Net Home Banking is Available at no extra charge when you sign up.

Choose a Program Credit Union Credit Union Acct. No.

Withdraw from:  Checking Savings 
*Payment will be automatically withdrawn the first week of every month.

I prefer to give this information over the phone. Please contact me at home.



   Members of Participating Organizations 

Members of participating organizations will still receive the $2 discount off the standard plan. Please indicate which one of the following organizations you belong to and your billing preference.

Choose a Program Participating Organization

Pay with:  Credit  CardMonthly check 

Credit Card Number       
Visa  Master Card American ExpressDiscover 
Expiration Date       

I prefer to give this information over the phone. Please contact me at home.



   Non Members

Even if you don't belong to a Credit Union or one of the above organizations, Q-Express.Net wants you as a valued customer. Feel free to enter the information below or contact us directly to make payment arrangements.


Choose a Program

Pay with:  Credit  CardMonthly check 

Credit Card Number       
Visa  Master Card American ExpressDiscover 
Expiration Date       

I prefer to give this information over the phone. Please contact me at home.



Have You Completed The Application?




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