Cyber Mesa
Agenda Sign-up

	Welcome to the Internet at Cyber Mesa!
	You will need a username and password to utilize your Agenda. For our part, we need your credit card information. Hence, we ask that you complete the sign-up form below.
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	Please fill out the secure form below. Use the Tab Key or your mouse to advance from one field to the next. If you have any questions, by all means give us a call at 1-888-988-2700 toll-free (988-9200 in Santa Fe).
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First Name

Last Name

Company
Address

City

State

Zip

We only require a company name if the account will be used for business.

	Area Code		Home Phone		Area Code		Work Phone

Your username must be a minimum of 3 characters, up to 12 characters, made up of letters - all lower case - and numbers. You can use an underscore [tom_jones] or a dash [grace-jones], but please do not use any other types of punctuation marks. Since your username must be unique to our system, you can check for availability before making a final selection.

	Username			Check Availability
	Password
				Retype your password

Your password must be 6 or more characters long in the interest of security. We also require that at least one character be a capital letter or a number to thwart would-be hackers. While your password should be something you can remember, please avoid using your username and/or your real name.

	Your account Type		Cyber Mesa Agenda		Monthly Account Fee	$7.95

Name on Card			Card Security Code what's this?
Credit Card No			Expiration Date		01 02 03 04 05 06 07 08 09 10 11 12   04 05 06 07 08 09 10 11 12 13 14 15 16
		Please avoid any spaces or dashes.			Month         Year

We ask for the following information so that we can give you your password over the telephone in the event that you misplace it.

Date of Birth			Mother's Maiden Name
		mm/dd/yyyy

All billing notices will be sent by email to your new account. If you want your bills to go to a different address (which can also be off-site), please type the address on the right.

Email Billing Address

	How did you hear about us?

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	Thanks for taking the time to provide the above information. Please read the Subscription Agreement and the Terms for Cyber Mesa Agenda below. If you agree to the terms, then go ahead and submit your information. After submitting the form, you will have the opportunity to print out your application and the Subscription Agreement.
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	Subscription Agreement
	I agree to pay Internet at Cyber Mesa the monthly charges and excess hours (if applicable) for access to the Internet. In addition, I authorize Internet at Cyber Mesa to charge my credit card monthly in the event that I have submitted my credit card details. I realize that the monthly charges are ongoing until I inform the Internet at Cyber Mesa in writing (by email, fax, or letter) to cancel my Internet access. Furthermore, I understand that the first month of access is prorated and all other months are billed at the start of the month. Therefore, if I elect to cancel my access after the first day of a given month, my account will continue until the end of the month in which I give written notice of cancellation without any refund due to me. I release the Internet at Cyber Mesa and Cyber Mesa Computer Systems from all liability in the event that the system goes down for any reason.
	Terms for Cyber Mesa Agenda
	Cyber Mesa will make every effort to ensure that the Agenda Server and all Cyber Mesa systems work smoothly. Cyber Mesa cannot be held responsible, however, for data loss or down time for any reason. Furthermore, the customer shoulders the responsibility of replicating his/her data to a local computer. If the customer does not elect to use the replication feature, then he/she understands that there is a risk that all data could be lost. Cyber Mesa does not provide technical support for Agenda. While the program is fairly intuitive, the obligation rests with the customer to learn the ins and outs by studying the Help file. If the customer shows no activity on the Cyber Mesa Agenda for more than 60 days, Cyber Mesa will assume that the customer no longer requires the service. The customer's Agenda will be deleted. If and when the customer terminates his/her Internet access account, the Agenda will be terminated as well. Likewise, failure to keep Cyber Mesa account payments current could lead to the elimination of the customer's Agenda. The limit for each Agenda is 20 megabytes. The program requires about 6mb, leaving about 14mb for data (that translates to about 3,500 email messages). If the limit is exceeded then no mail can be sent. The customer has the option, however, of archiving data on his/her local computer.

	I Agree, Submit Form		Cancel and Clear Form
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