Full Name: Address: Postcode: Phone Number: We will assign you a username. All you need to do is choose a password and an e-mail address. The password MUST be 6 to 8 characters and only contain letters or numbers. It is case sensitive. You MUST verify your password to confirm it. Your e-mail address MUST be different from your password Date Of Birth: DD/MM/YYYY Password: Verify Password: E-mail address: @surf3.net Modem type: 33.6k or less K56 Flex 56K X2 V.90 64KISDN 128K ISDN Select if known

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