ADI Internet Solutions -  Personal Web Site Registration Form

ADI Internet Solutions
Web Site Registration/Agreement

Your site will not be formally activated until you print out
and mail a copy of this form along with your signature to the address below. You can type in the required information in any place that has a box, however the signature and date must be filled out by hand

Existing /images/madiblack.GIF (2242 bytes)dial up customers may register for one free web site.

Email Address: 
Full Name: 
Username:
* Web Site Name: { 12 characters or less }

*Your web site name can be the same as your web site Username or it can be something completely different, but is must be different then any of our current /images/madiblack.GIF (2242 bytes) Personal Web Sites. The web site area name will appear in the URL people use to find your web page. For example, if your web site area name were "myfamily", the URL to your Worldwide Web homepage would be: http://personal.adiis.net/myfamily.

/images/madiblack.GIF (2242 bytes) now offers the ability for you to use Microsoft Front Page with your web site.  Front Page adds extra functionality that would otherwise require extra HTML programming and CGI scripting. If you are not familiar with Front Page or are not sure if you will use it, please check No - you can always have us enabled it at a later time.

Would you like your web site Microsoft Front Page enabled?   Yes     No


One line of text is used to describe your site on /images/madiblack.GIF (2242 bytes)'s User Free Sites page to point to your web site area. Please provide the information you wish to have displayed.
Title: 

Please describe the purpose and content of your web site :

DISCLAIMER. /images/smadired.GIF (2477 bytes), Inc. reserves the right to refuse placing materials into the this WWW server, and related areas, which may be deemed by /images/smadired.GIF (2477 bytes) to be offensive to potential readers, or which may be contrary to state and federal statutes. /images/smadired.GIF (2477 bytes) reserves the right to discontinue providing this service on your behalf for any cause deemed sufficient by /images/smadired.GIF (2477 bytes). By signing this agreement, you agree to absolve /images/smadired.GIF (2477 bytes) of any liability for the content and distribution of materials placed in your area by yourself or any other persons or entities. Any questions or disputes which arise in this regard must be corresponded in writing to representatives of /images/smadired.GIF (2477 bytes).

By mailing this form I agree to the above stated information
I also understand that my site will not be formally activated until I print out and mail a copy of this form along with my signature to:

/images/madiblack.GIF (2242 bytes)
PO Box
Marshalltown, Iowa 50158

Signature: __________________________________

Date: _______________

Print and Mail this Form,
then Click Here to return to the ADI Home Page.