N
eighbourhood
I
nternet
S
ervice
P
rovider
If you would like to put your name on the list, please enter the information below and we will contact you as soon as possible.
This information will be send via email.
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Name (first,last):
ID:
Company:
Address:
City, Postal code:
Country:
Province:
Phone Number:
Fax:
(Optional)
E-mail:
ID number of person that refered you:
High/Secondary school I support:
When 50 subscribers support a school, we will provide free internet access to that school.
Notes/Questions:
Please put my information on the list of potential subscribers to the Neigbourhood Internet Service.