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GCN Application

Sign-up form for Gustavus Community Network subscription (deprecated)

To sign up for GCN, please go to our on-line signup form. The application below is for historical reference only.


Gustavus Community Network Application

Choose your own user name and password. User name cannot contain spaces. Password must be at least 8 characters.

User Name:  __________________________@gustavus.ak.us

Password:  ____________________________

Name: __________________________

PO Box: __________________________

Phone: __________________________

List me in the community directory so others can look up my name, PO Box, phone, and e-mail address. You will not be listed unless you check this box.

E-Mail handling (check one or both):

Create a GCN e-mailbox for me. The address will be YourUserName@gustavus.ak.us

Please contact me at this e-mail address: __________________________
If you do not check this box, your billing reminders and important network news will be sent to your GCN mailbox -- YourUserName@gustavus.ak.us 

STATEMENT OF RESPONSIBILITY:

Access to the community network is granted to with the understanding that such access is a privilege and carries with it certain responsibilities.

Use of GCN to interfere with the privacy and security of other users, or for illegal purposes, is prohibited and may result in termination of access without warning.

Payment must be received no later than the first of each month to ensure continued access.

I HAVE READ THE ABOVE STATEMENT AND AGREE TO ITS PROVISIONS.

SIGNATURE ___________________________________ DATE ________________

RETURN ORIGINAL SIGNED FORM AND $55 PAYMENT FOR SETUP AND FIRST MONTH TO:

Gustavus Community Network
c/o Bruce Paige
P. O. Box 114
Gustavus, AK 99826


(GCN USE ONLY)

DATE ____________________________

 

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