Hello, and thank you for applying for fax services with us!

This form provides information on signing up for any of Interpage's fax services, as well as a sign up form which you may print out from your WWW browser and fax or postal mail back to us when complete. A signed form is always required, so it may not be e-mailed back to us, since there is no way we can obtain a signature with a text-only file. If you can not print out this form, or prefer not to, we will be glad to fax or postal mail one to you. Please call or e-mail us to request a fax/mailed signup form.

This form is a Fax Services form with can be used to apply for any Interpage Fax-based service. To apply for other services, please return to the main/home page, and select the "Sign Up with Interpage!" icon.

We prefer to have our individual users pay by credit card. Doing so generally ensures that we can have most accounts set up within a day or so, sometimes less. We gladly accept the American Express Card, Visa, Mastercard and Discover.

We also accept check payments from individuals or companies for Tier III or higher accounts (generally $250/month base rate before usage). Sorry, check payment is not available for accounts less than Tier III.

Companies and other applicants for Tier III (or higher) rate plans may apply for a Business Credit Application in conjunction with this service agreement. A copy of the Business Credit Application may be found on our WWW Form Server; please log in as guest (lower case) and do not use a password. When signing up by credit card, PLEASE ENCLOSE A LEGIBLE PHOTOCOPY OR IMPRINT OF YOUR CREDIT CARD. We can not process a credit-card application without a legible photocopy or imprint.

We accept the following cards:

and Discover.

For immediate sign-up with a credit card, please fill out/edit the form below and fax it back to us at +1 (617) 850-0420. Please fill out all applicable items. (For example, if you are signing up for one of our Fax services, and the given fax service does not require/support pager noitifcation, you can skip all lines having to do with paging). If you aren't sure what lines to fill out, please give us a call at +1 (617) 696-8000 or +1 (510) 315-2750 or send e-mail to questions@interpage.net.

At the very minimum, we require your name, address, phone number to reach you at, driver's license # (for check payment), credit card #, expiration date, signature, and photocopy/imprint of the card (credit card), valid student ID (student discount), and all sign-ups require a signature indicating that you agree to abide by our terms for service.

Our terms of service/policies are available via our WWW server or via telnet access by logging in to interpage.net as a guest without using a password.

If you do not have access to a fax, you may mail your application to:

Interpage NSI
Mail Stop 2001, Attn: Activations
Box 4022
Hartford, CT

Account setup may take up to a day, or we may be able to set you up right away, depending on the service(s) you are signing up for. We may need to configure our system for your fax provider, paging service provider (for fax paging notification), Internet Service provider, etc., and will not bill you until your account is properly configured.

If you intend to pay by check, then please print out the sign-up sheet below and mail it to us with your check. We will add your account a few days after we receive the check and completed form from you.

If you have any questions about signing up, or other questions about our service, please mail questions@interpage.net or call +1 (617) 696-8000. Our fax number is +1 (617) 850-0420.

Thank you for your interest in Interpage!

            City, state, zip:

             Day voice phone:
         Evening voice phone:
Pager for us to reach you at:
                   Fax phone:

Email for us to reach you at:

           Preferred user ID:

The user ID will be your email address, e.g., myid@interpage.net. (If the ID you select is currently in use on our system, we will try to find something close to it. Feel free to include second and third choices. IDs can be 8 alpha characters with no punctuation or spaces.)

Please select a rate plan or specify the service which you think will suit your needs. You may change plans at will, but the change will only take effect for your NEXT billing cycle (i.e., you cannot change mid-cycle).

Rate plan and fax service descriptions/information is available from the main fax menu page or directly from our rate sheet. You may also access our telnet server (log in as "guest"), or you may mail questions@interpage.net for a rate quote from our support staff. If rate plan information is omitted, you will be set up under the Basic service plan, which you may make changes to after you have been set up.

                    Rate Plan:

Please complete the following for each pager you wish to be configured into the system. If paging is not required for your account, please omit and continue to the next section.


Pager system name/Cust. Svc.#:
         Pager access number*:
            Pager Tel.# or ID:
 Max # of characters per page:

* If one of your entries (you can have a few pagers if you wish) is an Alpha pager, where you can receive text messages, please provide the TAP/IXO protocol (modem) access number, if you know it. If not, we will call the paging company listed in the "Pager system" entry and ask them for you.

Default Settings (changeable at will by the user):

1. If you have subscribed to a fax service which utilizes pager
notification, between what hours of the day would you like to be paged?
(ie, 0000-2359 means all day, and you can have a number of entries, such
as 0900-1200, 1300-2359, 0000-2359 only when "urgent" is in the
subject, etc.): 

2. What Time Zone are you located in?

3. If you wish to employ Interpage's included e-mail forwarding service (not
required for most fax services), when would you like your e-mail
forwarded to you (like above) and to which accounts would you
like them forwarded? (ie, sort of like above, you can specify 0000-2359 to
john@cat.dog, but if "readme" (or whatever) is in the subject then mail to
lisa@simpsons.org as well. 

4. If you are using pager notification services, would you like to have
your pages held and then batched? Typically, a customer would use this
feature at night, and have all pages held until morning, when they are
sent out all at once, allowing the customer to quickly review the night's
mail. Please indicate the time during which mail should be held, and the
desired "batch" time when all pages should be sent. 

Thank you for taking the time to fill this out!

Please feel free to mail us at questions@interpage.net or call +1 (617) 696-8000 if you have any questions about this from, our rate plans, or anything else. We are always glad to help!

If this is a new activation and/or change of credit card billing, please read this statement and sign it. (Signature is required for service.)

I am aware of and fully understand all of Interpage's policies concerning my service with Interpage Network Services Inc. (INSI). I agree to abide by these policies, and understand that willful, negligent, or flagrant disregard for the policies set forth in the policy statement, or any other behavior which unreasonably compromises the stability, security, or operability of the Interpage system, will constitute sufficient grounds for immediate suspension and/or termination of service, at the sole discretion of INSI. I hereby waive all claims which I may assert against Interpage for service disruptions, outages, and difficulties, and understand and agree that I will not hold Interpage responsible for any losses, financial or otherwise, which I may experience as a result of a service difficulties.

I further agree that if paying by credit card that I will uphold the terms of my credit card agreement.

Please enclose a legible photocopy of your credit card. Thank you!

___________________________________        ______________________________
Credit Card Number        Exp. Date        Card Type

___________________________________        _______________________________
Printed Name                   Date        Signature

Mailing Address:

Interpage Network Services, Inc.
Mail Stop 2001 Attn: Activations
Box 4022
Hartford, CT 06147-4022

Fax Signup: +1 (617) 850-0420.

A copy of the Interpage Policy statement can be found on our WWW server, by telnet with a "guest" login, or a copy may be sent to you via e-mail or regular mail upon request.

Rev 0032/1997, (c)INSI 1994, 1998, 2000

Last modified 10/18/98